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General NPI Number Information
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NPI Number | 1437285368
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Entity Type | Organization
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Legal Business Name | HAVENS COUNSELING, INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 2330 BEACON ST STE 105
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City | FORT WAYNE
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State | IN
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Zip | 46805-3852
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Country | US
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Telephone | 260-602-8009
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Fax |
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Provider Business Mailing Address
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Address Line | 624 PELLSTON CT
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City | FORT WAYNE
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State | IN
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Zip | 46825-2270
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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 | PRESIDENT
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Name | MS. MARJORIE L. HAVENS
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Credential | LMFT
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Telephone | 260-489-8138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 35001539A
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License Number State | IN
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