Provider Demographics
NPI:1598330417
Name:SAFEHAVEN COMMUNITY COUNSELING SERVICES
Entity Type:Organization
Organization Name:SAFEHAVEN COMMUNITY COUNSELING SERVICES
Other - Org Name:SAFEHAVEN COMMUNITY COUNSELING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:THERAPIST/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:205-570-8233
Mailing Address - Street 1:326 GOLDENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:AL
Mailing Address - Zip Code:35570-3571
Mailing Address - Country:US
Mailing Address - Phone:205-570-8233
Mailing Address - Fax:205-449-0049
Practice Address - Street 1:326 GOLDENWOOD DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:AL
Practice Address - Zip Code:35570-3571
Practice Address - Country:US
Practice Address - Phone:205-570-8233
Practice Address - Fax:205-449-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty