Healthcare Provider Details

I. General information

NPI: 1750292645
Provider Name (Legal Business Name): HER HAVEN COLLECTIVE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 S 400 E
LINDON UT
84042-2120
US

IV. Provider business mailing address

139 S 400 E
LINDON UT
84042-2120
US

V. Phone/Fax

Practice location:
  • Phone: 385-230-4122
  • Fax:
Mailing address:
  • Phone: 385-230-4122
  • 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: EMILY HANNAH RICHINS
Title or Position: OWNER
Credential:
Phone: 385-230-4122