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General NPI Number Information
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NPI Number | 1164370474
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Entity Type | Organization
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Legal Business Name | HAVEN SHORE COUNSELING LLC
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/22/2026
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Provider Practice Location Address
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Address Line | 715 S SUGAR ST
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City | CELINA
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State | OH
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Zip | 45822-2493
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Country | US
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Telephone | 419-303-6324
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Fax |
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Provider Business Mailing Address
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Address Line | 715 S SUGAR ST
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City | CELINA
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State | OH
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Zip | 45822-2493
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | STACIE RHODES
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Credential |
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Telephone | 419-303-6324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 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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