Haynes, Jeffrey

Haynes, Jeffrey is an individual health care provider with primary practice located at 1 Long Wharf Dr , New Haven CT 06511-5946. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Haynes, Jeffrey can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
1 Long Wharf Dr New Haven CT 06511-5946
Phone: (203) 781-4600
Fax: (203) 781-4624
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 000874 Connecticut

Profile Details

NPI number 1275659450
LBN Legal business name Haynes, Jeffrey
Credentials LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Jan 24th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275659450 NPPES
Connecticut MEDICAID 008022626
Connecticut Other 008050283
Connecticut MEDICAID 500000315
Connecticut MEDICAID 004082286

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