Provider Demographics
NPI:1013672096
Name:HASKINS, JAIMY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAIMY
Middle Name:
Last Name:HASKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 S MERIDIAN ST STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-2912
Mailing Address - Country:US
Mailing Address - Phone:317-992-1919
Mailing Address - Fax:
Practice Address - Street 1:7550 S MERIDIAN ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-2912
Practice Address - Country:US
Practice Address - Phone:317-992-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009637A104100000X
IN34009862A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker