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General NPI Number Information
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NPI Number | 1225873615
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Entity Type | Organization
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Legal Business Name | HAVEN ROOM THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 06/27/2024
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 28210 PASEO DRIVE, SUITE 190 OFFICE 232
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-3753
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Country | US
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Telephone | 147-776-4626
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Fax | 813-336-8404
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Provider Business Mailing Address
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Address Line | 28210 PASEO DRIVE, SUITE 190 OFFICE 232
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-3753
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Country | US
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Telephone | 147-776-4626
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Fax | 813-336-8404
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Authorized Official
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Title or Position | MANAGER
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Name | ASHLEY HOPSON FRANCIS
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Credential | LCSW
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Telephone | 813-776-4626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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