Provider Demographics
NPI:1770616435
Name:HAVEN COUNSELING SERVICES
Entity type:Organization
Organization Name:HAVEN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MARAGUERITE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:440-740-1258
Mailing Address - Street 1:8180 BRECKSVILLE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1353
Mailing Address - Country:US
Mailing Address - Phone:440-740-1258
Mailing Address - Fax:440-740-0539
Practice Address - Street 1:8180 BRECKSVILLE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1353
Practice Address - Country:US
Practice Address - Phone:440-740-1258
Practice Address - Fax:440-740-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9261281Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER