Provider Demographics
NPI:1174686638
Name:HOWELL, HAVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HAVEN
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 KIMBARK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5583
Mailing Address - Country:US
Mailing Address - Phone:720-652-0416
Mailing Address - Fax:720-652-0408
Practice Address - Street 1:500 KIMBARK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5583
Practice Address - Country:US
Practice Address - Phone:720-652-0416
Practice Address - Fax:720-652-0408
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO298212084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO29821OtherSTATE LICENSE
COF27122Medicare UPIN