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General NPI Number Information
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NPI Number | 1033819446
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Entity Type | Organization
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Legal Business Name | HAVEN OF THE HEART COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 115 W BROADWAY ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-5628
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Country | US
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Telephone | 501-487-1558
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Fax |
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Provider Business Mailing Address
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Address Line | 2908 WATERFRONT CV
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City | SHERWOOD
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State | AR
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Zip | 72120-8041
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Country | US
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Telephone | 501-920-9625
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHALAE N HESSELBEIN
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Credential | LCSW
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Telephone | 501-920-9625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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