Provider Demographics
NPI:1265586267
Name:HAYNIE-PENA, CARA (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:CARA
Middle Name:
Last Name:HAYNIE-PENA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5262 S STAPLES ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4116
Mailing Address - Country:US
Mailing Address - Phone:361-510-0557
Mailing Address - Fax:361-850-8853
Practice Address - Street 1:5262 S STAPLES ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4116
Practice Address - Country:US
Practice Address - Phone:361-510-0557
Practice Address - Fax:361-850-8853
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15667101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health