Individual provider · Type 1 NPI
Kurtis Haynesworth
Professional Counselor · Pocono Lake, PA
NPI number
1033016779
Active
Practice location
124 Village Park Dr
Pocono Lake, PA 18347-8215
Mailing address
114 W 3rd St
Wind Gap, PA 18091-1507
Other practice locations
- 114 W 3rd St, Wind Gap, PA 18091-1507 · (570) 994-8878
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | PC021192 (PA) |
Professional Counselor: Definition to come...
About NPI 1033016779
Kurtis Haynesworth's National Provider Identifier is 1033016779, issued on Oct 26, 2026. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Pocono Lake, PA. The record was last updated on Oct 26, 2026.