MEDICARE: HAVEN MENTAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1295608479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN MENTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	1401 SKYLINE BLVD STE 270
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58503-1325
Country	:	US
Telephone Number	:	701-751-7500
Fax Number	:	701-751-0928

Provider Business Practice Location Address
First Line	:	1401 SKYLINE BLVD STE 270
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58503-1325
Country	:	US
Telephone Number	:	701-751-7500
Fax Number	:	701-751-0928

Authorized Official
Title or Position	:	CO-OWNER/FNP
Name	:	ASHLEY MURREY
Credential	:
Telephone Number	:	701-751-7500

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	05/27/2026

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