Provider Demographics
NPI:1306488945
Name:THE HAVEN CENTER FOR THERAPY AND WELLNESS, LLC
Entity type:Organization
Organization Name:THE HAVEN CENTER FOR THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:INDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:443-798-2450
Mailing Address - Street 1:1531 ROCKVILLE PIKE # 1015
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1601
Mailing Address - Country:US
Mailing Address - Phone:443-798-2450
Mailing Address - Fax:443-898-9703
Practice Address - Street 1:4552 HIDDEN STREAM CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117
Practice Address - Country:US
Practice Address - Phone:443-798-2450
Practice Address - Fax:443-898-9703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)