Provider Demographics
NPI:1366204174
Name:HAYNES, SARAH EIZABETH (LPC-A)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:EIZABETH
Last Name:HAYNES
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S FRIENDSWOOD DR # 122
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5408
Mailing Address - Country:US
Mailing Address - Phone:281-229-2607
Mailing Address - Fax:
Practice Address - Street 1:1620 S FRIENDSWOOD DR # 122
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5408
Practice Address - Country:US
Practice Address - Phone:281-229-2607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional