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MARIO DWAYNE HAINESWORTH SR.
NPI 1306458245
Counselor - Professional in Warren, OH

Active since August 21, 2020PECOS Enrolled
1705 WOODLAND ST NE, WARREN, OH 44483(330) 719-0660 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mario Dwayne Hainesworth Sr. NPPES

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

MARIO DWAYNE HAINESWORTH SR. (NPI 1306458245) is an individual professional provider in Warren, Ohio, licensed in Ohio (E.2607289) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1306458245
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMARIO DWAYNE HAINESWORTH SR.
Location Address1705 WOODLAND ST NEWarren, OH 44483-5348
Mailing Address1705 Woodland St NeWarren, OH 44483-5348 · (330) 469-6777
Phone(330) 719-0660
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateAugust 21, 2020
Last NPPES UpdateJuly 1, 2026
NPPES CertifiedJuly 1, 2026
✔ NPI 1306458245 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 OH · E.2607289
1705 WOODLAND ST NE, Warren, OH 44483
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mario Dwayne Hainesworth Sr. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103383377
PECOS Enrollment IDI20260806004708
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mario Hainesworth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Thrive Counseling LLC
Same address
Mental Health
1705 WOODLAND ST NE
Warren, OH 44483
  • Reassigned Medicare billing, Ohio enrollment
  • 13 clinicians in this Medicare group
NPI 1699246116 (330) 469-6777

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REGIS JOHN SHUTTIC JR.
Peer Specialist
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777
JASE LIEBHART
Counselor (Addiction (Substance Use Disorder))
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777
MADELINE LAPOLLA
Counselor (Mental Health)
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777
SCOTT ENTZI M.ED.
Behavior Technician
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777
ZOE COFFEE
Social Worker
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777
MRS. CRYSTAL EVON PANKEY
Social Worker
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777
MEGAN MCBRIDE
Counselor (Addiction (Substance Use Disorder))
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777
PATRICK SAVAGE
Counselor (Addiction (Substance Use Disorder))
1705 WOODLAND ST NE
WARREN, OH 44483
Trumbull County (330) 469-6777

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 Mario Hainesworth's NPI number?

The NPI number for Mario Hainesworth is 1306458245. It was assigned to this individual provider in the NPPES registry on August 21, 2020.

Where is Mario Hainesworth located?

Mario Hainesworth practices at 1705 Woodland St NE, Warren, OH 44483. The listed phone number is (330) 719-0660.

What is Mario Hainesworth's specialty?

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

Is Mario Hainesworth enrolled in Medicare?

Yes. Mario Hainesworth is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mario Hainesworth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mario Hainesworth reassigns Medicare benefits to Thrive Counseling LLC (Warren, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mario Hainesworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mario Hainesworth was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.