Provider Demographics
NPI:1891467064
Name:HAINES, DANITA K (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DANITA
Middle Name:K
Last Name:HAINES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6672 CASTLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-8134
Mailing Address - Country:US
Mailing Address - Phone:850-490-7947
Mailing Address - Fax:
Practice Address - Street 1:7552 NAVARRE PKWY UNIT 7
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7312
Practice Address - Country:US
Practice Address - Phone:850-490-7947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty