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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

KURTIS HAYNESWORTH
NPI 1033016779
Counselor - Professional in Pocono Lake, PA

Active since October 26, 2026
124 VILLAGE PARK DR, POCONO LAKE, PA 18347(570) 307-9079 Get Directions Write a Review

NPPES record added: October 26, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kurtis Haynesworth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KURTIS HAYNESWORTH (NPI 1033016779) is an individual professional provider in Pocono Lake, Pennsylvania, licensed in Pennsylvania (PC021192) and active in the NPI registry since October 2026. He maintains a secondary practice location in Wind Gap.

NPPES Registry Identity

NPI1033016779
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameKURTIS HAYNESWORTH
Location Address124 VILLAGE PARK DRPocono Lake, PA 18347-8215
Mailing Address114 W 3rd StWind Gap, PA 18091-1507
Phone(570) 307-9079
Sole ProprietorNo
Enumeration DateOctober 26, 2026
NPPES CertifiedOctober 25, 2026
✔ NPI 1033016779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in PA · PC021192
124 VILLAGE PARK DR, Pocono Lake, PA 18347
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Secondary Practice Location 1

Location 1114 W 3rd StWind Gap, PA 18091-1507 · Phone (570) 994-8878

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kurtis Haynesworth's NPI number?

The NPI number for Kurtis Haynesworth is 1033016779. It was assigned to this individual provider in the NPPES registry on October 26, 2026.

Where is Kurtis Haynesworth located?

Kurtis Haynesworth practices at 124 Village Park Dr, Pocono Lake, PA 18347. The listed phone number is (570) 307-9079.

What is Kurtis Haynesworth's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Kurtis Haynesworth was last updated on October 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.