Provider Demographics
NPI:1417566894
Name:HAVEN HEALING PLLC
Entity Type:Organization
Organization Name:HAVEN HEALING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:513-535-1139
Mailing Address - Street 1:5970 FAIRVIEW RD STE 414
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3179
Mailing Address - Country:US
Mailing Address - Phone:513-535-1139
Mailing Address - Fax:980-498-7881
Practice Address - Street 1:5970 FAIRVIEW RD STE 414
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3179
Practice Address - Country:US
Practice Address - Phone:513-535-1139
Practice Address - Fax:980-498-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty