Provider Demographics
NPI:1285144022
Name:HEALING HAVEN COUNSELING, PLLC
Entity type:Organization
Organization Name:HEALING HAVEN COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-318-6317
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-0470
Mailing Address - Country:US
Mailing Address - Phone:801-318-6317
Mailing Address - Fax:
Practice Address - Street 1:1220 N MAIN ST STE 11
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-4016
Practice Address - Country:US
Practice Address - Phone:801-318-6317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty