Provider Demographics
NPI:1063838696
Name:HAVEN OF HOPE COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HAVEN OF HOPE COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON-MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCAT
Authorized Official - Phone:518-982-5376
Mailing Address - Street 1:1471 ROUTE 9
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-6500
Mailing Address - Country:US
Mailing Address - Phone:518-982-5376
Mailing Address - Fax:
Practice Address - Street 1:1471 ROUTE 9
Practice Address - Street 2:SUITE 201
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-6500
Practice Address - Country:US
Practice Address - Phone:518-982-5376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000806-1101YM0800X
NY001903-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty