Basic Information
| Provider Information | |||||||||
| NPI: | 1477010692 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAFE HAVEN COUNSELING WNC, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1924 US HIGHWAY 70 | ||||||||
| Address2: | |||||||||
| City: | SWANNANOA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287789305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284500614 | ||||||||
| FaxNumber: | 8285441201 | ||||||||
| Practice Location | |||||||||
| Address1: | 1141 MONTREAT RD OFC 8 | ||||||||
| Address2: | |||||||||
| City: | BLACK MOUNTAIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287113231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284500614 | ||||||||
| FaxNumber: | 8285441201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2019 | ||||||||
| LastUpdateDate: | 02/25/2019 | ||||||||
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| AuthorizedOfficialLastName: | TALBOT | ||||||||
| AuthorizedOfficialFirstName: | TRACI | ||||||||
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| AuthorizedOfficialTitleorPosition: | SOLE MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 8284500614 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.