CHANELLE HAYWOOD LMFT
NPI 1649013848
Marriage & Family Therapist in San Pedro, CA
About Chanelle Haywood Lmft NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHANELLE HAYWOOD LMFT (NPI 1649013848) is an individual marriage & family therapist in San Pedro, California, licensed in California (156305) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Chanelle Haywood Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Chanelle Haywood reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Pedro, CA 90731
- Reassigned Medicare billing, California enrollment
- 4 clinicians in this Medicare group
San Jose, CA 95113
- Reassigned Medicare billing, California enrollment
- 3,139 clinicians in this Medicare group
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.
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 Chanelle Haywood's NPI number?
The NPI number for Chanelle Haywood is 1649013848. It was assigned to this individual provider in the NPPES registry on June 15, 2024.
Where is Chanelle Haywood located?
Chanelle Haywood practices at 302 W 5th St Ste 308, San Pedro, CA 90731. The listed phone number is (424) 570-6955.
What is Chanelle Haywood's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Chanelle Haywood enrolled in Medicare?
Yes. Chanelle Haywood is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Chanelle Haywood's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Chanelle Haywood reassigns Medicare benefits to 2 organizations: Epiphany Counseling, Consulting & Treatment Services, PC (San Pedro, CA) and Grow Healthcare Group PC (San Jose, CA). Each 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 Chanelle Haywood'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 Chanelle Haywood was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Chanelle Haywood, LMFT · NPI 1649013848
Marriage & Family Therapist provider in San Pedro, California. Individual provider, active in the CMS NPPES registry since June 15, 2024.
## Identity
- **NPI:** 1649013848 (Entity type: Individual)
- **Enumerated:** June 15, 2024
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 156305 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 302 W 5TH ST STE 308, San Pedro, CA 90731-2750
- **Phone:** (424) 570-6955
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Epiphany Counseling, Consulting & Treatment Services, PC (NPI 1376922328, San Pedro, CA); Grow Healthcare Group PC (NPI 1154994846, San Jose, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Southern California Keck School Of Medicine, class of 2023
## Record status
- **NPPES last updated:** November 4, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1649013848) · Data from the CMS NPPES public registry.