ERIC HAINES (NPI# 1740831254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740831254 |
| Entity Type | Individual |
| Full Name | ERIC HAINES |
| Practice Address |
556 Clinton Ave S Rochester NY 14620-1105 |
| Mailing Address |
79 Glenridge Rd Glenville NY 12302-4523 |
| Practice Telephone | 5854428422 |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2020-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
34951 | NY | Behavioral Health & Social Service Providers |
| Y | 175T00000X | Peer Specialist | 35941 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01420800 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 835 W Main St, Rochester, NY 146112335 | 5854672230 |
| Street Address |
556 CLINTON AVE S |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14620-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235185612 | Conifer Park, Inc. | Clinic/Center | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2006-05-26 |
| 1861010662 | Leah Newman | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2020-07-08 |
| 1356974497 | Lisa Giglia | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2020-02-18 |
| 1538704788 | Timothy Stevens | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2019-11-12 |
| 1275091266 | Jeannette Judith Sampson | Registered Nurse | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2019-03-08 |
| 1427529585 | Jeremy Patrick Thayer | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-12-16 |
| 1780155457 | Nicole Renee Miller | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-12-06 |
| 1790278117 | Margo Anne Tremaine | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-06-11 |
| 1982195186 | Estelle Webster | Registered Nurse | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-05-23 |
| 1396249405 | Courtney Wachter | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974174 | Linda D Pratt | Speech-Language Pathologist | Rochester Hearing and Speech Center, 1000 Elmwood Ave Suite 400, Rochester, NY 14620 | 2020-02-20 |
| 1609417617 | Maisie Katherine Pipher | Physician Assistant | 110 Crittenden Blvd, Rochester, NY 14620 | 2019-10-01 |
| 1215592332 | Allison Mckeown | Student in an Organized Health Care Education/Training Program | 777 S. Clinton Avenue - Box Hh 37, Rochester, Ny 14620, Box Hh 37, Rochester, NY 14620 | 2019-05-03 |
| 1114495736 | Tabitha Domonique Griffin | Licensed Practical Nurse | 55 Forthill Terrace, Rochester, NY 14620 | 2018-11-13 |
| 1700371960 | Deborah Paul | Dermatology | 40 Celebration Dr # 697, Rochester, NY 14620 | 2018-06-28 |
| 1942725791 | Emily Catone | Nurse Practitioner | 252 Cobb Terrace, Rochester, NY 14620 | 2017-08-12 |
| 1104355593 | Acacia Palmer | Counselor | 150 Mount Hope Avenue, Rochester, NY 14620 | 2017-06-08 |
| 1750818803 | Meagan Michelle Goates | Student in an Organized Health Care Education/Training Program | 150 Crittenden Blvd, Rochester, NY 14620 | 2017-05-20 |
| 1386170470 | Kendall Battle | Licensed Practical Nurse | 479 South Ave Apt B, Rochester, NY 14620 | 2017-05-10 |
| 1285167700 | Gina Josette Kuehn | Student in an Organized Health Care Education/Training Program | 40 Celebration Dr # 278733, Rochester, NY 14620 | 2017-04-11 |
| Find all providers in zip 14620 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064832 | Kenneth Robert Lewis | Peer Specialist | 320 N Goodman St Ste 202320, Rochester, NY 14607-1185 | 2020-08-18 |
| 1487292793 | Robert Lee | Peer Specialist | 835 West Main St, Rochester, NY 14611-2335 | 2019-12-17 |
| 1811534670 | Christopher J Clase | Peer Specialist | 3 Stonewood Park Apt D, Rochester, NY 14616-3628 | 2019-11-28 |
| 1467011320 | Vinnie Dunnell Williams | Peer Specialist | 73 Brookfield Rd, Rochester, NY 14610-1015 | 2019-06-13 |
| 1881185122 | Tammy J Demarle | Peer Specialist | 320 N Goodman St Ste 202, Rochester, NY 14607-1186 | 2018-05-22 |
| 1912497223 | Lorrie Boyce | Peer Specialist | 344 N Goodman St, Rochester, NY 14607-1146 | 2018-05-11 |
| 1366948424 | Monekia Michelle Moore | Peer Specialist | 320 North Goodman Street, Rochester, NY 14607 | 2018-04-05 |
| 1366950164 | Tina Amico | Peer Specialist | 687 Lee Rd Ste 185c, Rochester, NY 14606-4258 | 2018-01-15 |
| 1982211850 | Sharon Thaxton | Peer Specialist | 835 W Main St, Rochester, NY 14611-2335 | 2020-09-25 |
| 1932710308 | Megan B Smith | Peer Specialist | 1 Mustard St, Rochester, NY 14609-6980 | 2020-08-11 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.