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General NPI Number Information
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NPI Number | 1265207831
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN COUNSELING, LLC
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Dates
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Enumeration Date | 11/23/2023
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Last Update Date | 11/23/2023
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Provider Practice Location Address
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Address Line | 8927 S SADDLE HORN DR
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City | IDAHO FALLS
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State | ID
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Zip | 83404-4731
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Country | US
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Telephone | 479-640-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 8927 S SADDLE HORN DR
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City | IDAHO FALLS
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State | ID
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Zip | 83404-4731
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Country | US
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Telephone | 479-640-1981
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | AMY WEIR
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Credential | LPC
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Telephone | 479-640-1981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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