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General NPI Number Information
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NPI Number | 1891647970
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Entity Type | Individual
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Provider Name | GITANA ALICIA HAVNER M.A.ED, LCMHCA, NCC
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Gender | Female
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1401 LONG ST
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City | HIGH POINT
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State | NC
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Zip | 27262-2541
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Country | US
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Telephone | 336-889-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 902 BONNER DR
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City | JAMESTOWN
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State | NC
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Zip | 27282-8948
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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 |
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Name |
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Credential |
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Telephone |
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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 | A22516
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License Number State | NC
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