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Individual

MS. SALLY IRONSIDE HAYNES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC, MAC, EMDR CERT

Contact information

Practice address
611 SULLIVAN RD, STATESVILLE, NC 28677-3437
(704) 762-7400
Mailing address
PO BOX 5685, STATESVILLE, NC 28687-5685
(704) 762-7400

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
29553
FL
101YP2500X
Professional Counselor
Primary
19409
NC

Other

Enumeration date
06/15/2012
Last updated
03/11/2024
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