Individual
MS. NIKKI HAYNESWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12621 N TATUM BLVD, #1629, PHOENIX, AZ 85032
(480) 269-2202
Mailing address
12621 N TATUM BLVD, #1629, PHOENIX, AZ 85032
(585) 353-6868
(602) 266-9025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
007895
NY
101YP2500X
Professional Counselor
Primary
LPC-21169
AZ
Other
Enumeration date
09/07/2018
Last updated
02/01/2024
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