Provider Demographics
NPI:1407395031
Name:HAVEN PROFESSIONAL COUNSELING
Entity Type:Organization
Organization Name:HAVEN PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWELS
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:989-600-3119
Mailing Address - Street 1:713 ASHMAN ST
Mailing Address - Street 2:STE. D
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4996
Mailing Address - Country:US
Mailing Address - Phone:989-600-3119
Mailing Address - Fax:
Practice Address - Street 1:713 ASHMAN ST
Practice Address - Street 2:STE. D
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4996
Practice Address - Country:US
Practice Address - Phone:989-600-3119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty