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General NPI Number Information
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NPI Number | 1376383687
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN THERAPY
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 2625 HARMONY PARK XING
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City | SPRING
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State | TX
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Zip | 77386-4475
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Country | US
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Telephone | 832-324-5318
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Fax | 940-260-7988
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Provider Business Mailing Address
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Address Line | 3431 RAYFORD RD # 200-155
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City | SPRING
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State | TX
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Zip | 77386-4943
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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 | LEAD CLINICIAN
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Name | GERISHIA VICTORIA DAVIS
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Credential | LCSW
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Telephone | 940-260-7926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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