Provider Demographics
NPI:1992903272
Name:HAYNES, MELANIE LOUISE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:LOUISE
Last Name:HAYNES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:DAVIE
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-758-7332
Mailing Address - Fax:661-758-7302
Practice Address - Street 1:930 F ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-2040
Practice Address - Country:US
Practice Address - Phone:661-758-7300
Practice Address - Fax:661-758-7302
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical