Provider Demographics
NPI:1003181017
Name:LOCKHART, HAINES III (LMHC)
Entity Type:Individual
Prefix:MR
First Name:HAINES
Middle Name:
Last Name:LOCKHART
Suffix:III
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W MAIN ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-8949
Mailing Address - Country:US
Mailing Address - Phone:585-301-2395
Mailing Address - Fax:315-331-0897
Practice Address - Street 1:19 W MAIN ST
Practice Address - Street 2:SUITE 150
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-8949
Practice Address - Country:US
Practice Address - Phone:585-301-2395
Practice Address - Fax:315-331-0897
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0016701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health