Provider Demographics
NPI:1518220482
Name:SAFE HAVEN COUNSELING CENTER
Entity Type:Organization
Organization Name:SAFE HAVEN COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WAGGONER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S, NCC
Authorized Official - Phone:281-678-4622
Mailing Address - Street 1:4808 FAIRMONT PKWY # 361
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3722
Mailing Address - Country:US
Mailing Address - Phone:281-678-4622
Mailing Address - Fax:832-872-2033
Practice Address - Street 1:7433 HINSDALE DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-1113
Practice Address - Country:US
Practice Address - Phone:281-678-4622
Practice Address - Fax:832-872-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-16
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65480101Y00000X, 101YP2500X
101YA0400X
TX1245389101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty