Provider Demographics
NPI:1497437313
Name:HAYMAKER, SHAWN (LMHC, ATR)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:HAYMAKER
Suffix:
Gender:M
Credentials:LMHC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55996
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-0996
Mailing Address - Country:US
Mailing Address - Phone:765-343-2025
Mailing Address - Fax:
Practice Address - Street 1:6151 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1838
Practice Address - Country:US
Practice Address - Phone:812-807-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health