Provider Demographics
NPI:1376383687
Name:SAFE HAVEN THERAPY
Entity type:Organization
Organization Name:SAFE HAVEN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GERISHIA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:940-260-7926
Mailing Address - Street 1:3431 RAYFORD RD # 200-155
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2625 HARMONY PARK XING
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4475
Practice Address - Country:US
Practice Address - Phone:832-324-5318
Practice Address - Fax:940-260-7988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty