Provider Demographics
NPI:1518606938
Name:MARCI HAINES PSYD LLC
Entity Type:Organization
Organization Name:MARCI HAINES PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAINES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:623-680-6461
Mailing Address - Street 1:8966 W YUKON DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-6448
Mailing Address - Country:US
Mailing Address - Phone:623-680-6461
Mailing Address - Fax:
Practice Address - Street 1:8966 W YUKON DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-6448
Practice Address - Country:US
Practice Address - Phone:623-680-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty