Provider Demographics
NPI:1255027918
Name:PEACEFUL HAVEN COUNSELING, PLLC
Entity type:Organization
Organization Name:PEACEFUL HAVEN COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-659-0142
Mailing Address - Street 1:5769 N HARCOURT DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8470
Mailing Address - Country:US
Mailing Address - Phone:208-659-0142
Mailing Address - Fax:
Practice Address - Street 1:1910 NORTHWEST BLVD STE 206
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2676
Practice Address - Country:US
Practice Address - Phone:208-659-0142
Practice Address - Fax:208-500-2707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty