Provider Demographics
NPI:1932252822
Name:HAVENS, JUDITH A (LMHC, LADC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:HAVENS
Suffix:
Gender:F
Credentials:LMHC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 POINT RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1937
Mailing Address - Country:US
Mailing Address - Phone:508-748-2459
Mailing Address - Fax:
Practice Address - Street 1:310 POINT RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1937
Practice Address - Country:US
Practice Address - Phone:508-826-1027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA878101YA0400X
MA1023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health