Healthcare Provider Details

I. General information

NPI: 1396490165
Provider Name (Legal Business Name): THE HAVEN HOLISTIC SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2022
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8245 FARNSWORTH RD SUITE B
WATERVILLE OH
43566
US

IV. Provider business mailing address

8245 FARNSWORTH RD SUITE B
WATERVILLE OH
43566
US

V. Phone/Fax

Practice location:
  • Phone: 419-276-3946
  • Fax:
Mailing address:
  • Phone: 419-276-3946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HANNAH VORST
Title or Position: OWNER/CEO
Credential: MSW, LISW-S
Phone: 419-276-3946