Healthcare Provider Details

I. General information

NPI: 1174454441
Provider Name (Legal Business Name): SAFE HAVEN THERAPEUTIC SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 BRAGG BLVD STE A
FAYETTEVILLE NC
28303-4141
US

IV. Provider business mailing address

2501 BRAGG BLVD STE A
FAYETTEVILLE NC
28303-4141
US

V. Phone/Fax

Practice location:
  • Phone: 910-364-9849
  • Fax:
Mailing address:
  • Phone:
  • 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: MOLLIE DUFFY
Title or Position: OWNER
Credential: MS,LCMHCA,NCC
Phone: 785-307-9738