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General NPI Number Information
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NPI Number | 1770389033
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Entity Type | Organization
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Legal Business Name | HEALING HAVEN COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 65 LADY SLIPPER DR
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City | WAYNESBORO
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State | VA
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Zip | 22980-8374
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Country | US
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Telephone | 304-815-4979
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 284
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City | CRIMORA
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State | VA
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Zip | 24431-0284
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Country | US
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Telephone | 540-324-8787
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JAMIE LYNN JACKSON
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Credential |
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Telephone | 304-815-4979
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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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