MEDICARE: AMY HAAKENSON

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	101YM0800X	Mental Health Counselor		NC

General Provider Information

NPI Number	:	1649105149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HAAKENSON

Provider Business Mailing Address
First Line	:	159 TRAVIS RD
Second Line	:
City	:	CULLOWHEE
State	:	NC
Zip	:	28723-7806
Country	:	US
Telephone Number	:	253-495-8330
Fax Number	:

Provider Business Practice Location Address
First Line	:	628 7TH AVE E
Second Line	:
City	:	HENDERSONVILLE
State	:	NC
Zip	:	28792-3801
Country	:	US
Telephone Number	:	828-696-8263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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