Provider Demographics
NPI:1851002901
Name:SAFE HAVEN PSYCHIATRICS PLLC
Entity Type:Organization
Organization Name:SAFE HAVEN PSYCHIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, PMHNP-BC
Authorized Official - Phone:980-445-8063
Mailing Address - Street 1:9338 AMES HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-8787
Mailing Address - Country:US
Mailing Address - Phone:980-445-8063
Mailing Address - Fax:
Practice Address - Street 1:3719 LATROBE DR STE 850B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4827
Practice Address - Country:US
Practice Address - Phone:980-445-8063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty