Provider Demographics
NPI:1093605354
Name:THE REFLECTIVE HAVEN LLC
Entity type:Organization
Organization Name:THE REFLECTIVE HAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARX
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:507-459-6604
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55974-0042
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:145 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:MN
Practice Address - Zip Code:55974
Practice Address - Country:US
Practice Address - Phone:507-459-6604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical