MEDICARE: HOLISTIC HAVEN COUNSELING

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

General Provider Information

NPI Number	:	1831914779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC HAVEN COUNSELING

Provider Business Mailing Address
First Line	:	207 WASECA AVE
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-3530
Country	:	US
Telephone Number	:	401-203-4883
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 WASECA AVE
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-3530
Country	:	US
Telephone Number	:	401-203-4883
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LEAH HOFFMANN
Credential	:	LICSW
Telephone Number	:	401-338-8946

Provider Enumeration Date	:	11/16/2024
Last Update Date	:	11/16/2024

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