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General NPI Number Information
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NPI Number | 1962322388
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Entity Type | Organization
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Legal Business Name | HAVEN PATH THERAPY
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 312 CRYSTAL SPRINGS LN N
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City | KEIZER
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State | OR
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Zip | 97303-3863
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Country | US
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Telephone | 541-905-0109
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Fax |
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Provider Business Mailing Address
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Address Line | 312 CRYSTAL SPRINGS LN N
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City | KEIZER
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State | OR
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Zip | 97303-3863
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Country | US
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Telephone | 541-905-0109
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH PROVIDER
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Name | TARANUM CHAUDRY
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Credential | LMFT, PH.D.
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Telephone | 541-905-0109
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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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