Provider Demographics
NPI:1932336054
Name:HAYNES, ANNIE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:MARIE
Last Name:HAYNES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:DERMOTT
Mailing Address - State:AR
Mailing Address - Zip Code:71638-0509
Mailing Address - Country:US
Mailing Address - Phone:870-942-3000
Mailing Address - Fax:870-538-5412
Practice Address - Street 1:233 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:AR
Practice Address - Zip Code:71663-9230
Practice Address - Country:US
Practice Address - Phone:870-737-2221
Practice Address - Fax:855-878-5991
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical