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General NPI Number Information
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NPI Number | 1942191697
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Entity Type | Organization
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Legal Business Name | CHAOS HAVEN COUNSELING, LLC
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 2556 CORBIN RICHARDS RD
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City | COLUMBIA
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State | KY
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Zip | 42728-9426
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Country | US
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Telephone | 270-634-9263
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 762
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City | COLUMBIA
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State | KY
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Zip | 42728-0762
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Country | US
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Telephone | 270-634-9263
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | COURTNEY MCKINNEY
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Credential | LPCC, NCC
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Telephone | 270-634-9263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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