Provider Demographics
NPI:1215548870
Name:HAVEN CHRISTIAN COUNSELING LLC
Entity Type:Organization
Organization Name:HAVEN CHRISTIAN COUNSELING LLC
Other - Org Name:HAVEN CHRISTIAN COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-304-0572
Mailing Address - Street 1:3035 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2509
Mailing Address - Country:US
Mailing Address - Phone:804-304-0572
Mailing Address - Fax:
Practice Address - Street 1:3421 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-1821
Practice Address - Country:US
Practice Address - Phone:804-277-9122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-16
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health