Provider Demographics
NPI:1700173887
Name:HAYNES, KAREN ALICIA (LPC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ALICIA
Last Name:HAYNES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 KEPLERS LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2052
Mailing Address - Country:US
Mailing Address - Phone:832-687-2038
Mailing Address - Fax:
Practice Address - Street 1:24200 SOUTHWEST FWY STE 402-175
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5984
Practice Address - Country:US
Practice Address - Phone:832-687-2038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional