Provider Demographics
NPI:1699122218
Name:HAYNES, KEISHA (MS)
Entity type:Individual
Prefix:MRS
First Name:KEISHA
Middle Name:
Last Name:HAYNES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROTHSCHILD PL
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-7022
Mailing Address - Country:US
Mailing Address - Phone:202-787-0274
Mailing Address - Fax:
Practice Address - Street 1:4475 REGENCY PL
Practice Address - Street 2:SUITE 205
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3072
Practice Address - Country:US
Practice Address - Phone:240-427-3554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health