Provider Demographics
NPI:1871084152
Name:HAYNIE, BEKKI DIZE (LCSW, LMHP)
Entity type:Individual
Prefix:
First Name:BEKKI
Middle Name:DIZE
Last Name:HAYNIE
Suffix:
Gender:F
Credentials:LCSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36086 LANKFORD HIGHWAY
Mailing Address - Street 2:#308
Mailing Address - City:BELLE HAVEN
Mailing Address - State:VA
Mailing Address - Zip Code:23306
Mailing Address - Country:US
Mailing Address - Phone:757-442-6147
Mailing Address - Fax:757-442-6148
Practice Address - Street 1:36086 LANKFORD HIGHWAY
Practice Address - Street 2:#308
Practice Address - City:BELLE HAVEN
Practice Address - State:VA
Practice Address - Zip Code:23306
Practice Address - Country:US
Practice Address - Phone:757-442-6147
Practice Address - Fax:757-442-6148
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040103771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical