Healthcare Provider Details

I. General information

NPI: 1447198585
Provider Name (Legal Business Name): HAVEN COUNSELING COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3504 7TH AVE S
BIRMINGHAM AL
35222-3211
US

IV. Provider business mailing address

PO BOX 1163
PELHAM AL
35124-5163
US

V. Phone/Fax

Practice location:
  • Phone: 205-789-0065
  • Fax:
Mailing address:
  • Phone: 205-789-0065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KENDRA BUCKLEY
Title or Position: OWNER
Credential: LPC
Phone: 205-789-0065