Provider Demographics
NPI:1508200924
Name:HAVENS, CHRISTINE KAY (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:KAY
Last Name:HAVENS
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10987 FAIRMONT LN NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3501
Mailing Address - Country:US
Mailing Address - Phone:206-842-1710
Mailing Address - Fax:
Practice Address - Street 1:753 N 35TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8870
Practice Address - Country:US
Practice Address - Phone:206-498-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00006556101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health