Healthcare Provider Details

I. General information

NPI: 1265345276
Provider Name (Legal Business Name): HAVEN HOUSE COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 PARKWAY CIR STE 6
WEST MONROE LA
71292-8057
US

IV. Provider business mailing address

105 WIDGEON WAY
WEST MONROE LA
71291-9121
US

V. Phone/Fax

Practice location:
  • Phone: 214-505-0118
  • Fax:
Mailing address:
  • Phone: 214-500-5118
  • 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: MRS. FREDDIE HODGES AMOS
Title or Position: COUNSELOR AND OWNER
Credential: LPC
Phone: 214-505-0118