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General NPI Number Information
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NPI Number | 1609629252
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Entity Type | Organization
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Legal Business Name | HAVEN FOR HEALING
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Dates
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Enumeration Date | 04/11/2024
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 100 WILTON PASTURE LN APT 302
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-7624
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Country | US
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Telephone | 143-487-2315
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Fax |
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Provider Business Mailing Address
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Address Line | 113 LEE LN
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City | GORDONSVILLE
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State | VA
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Zip | 22942-9235
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Country | US
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Telephone | 143-487-2315
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | TIFFANI-RAE ANN SMITH
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Credential | LPC
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Telephone | 434-218-0561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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