Provider Demographics
NPI:1417834151
Name:THERAPY HAVEN SUPPORT INC
Entity type:Organization
Organization Name:THERAPY HAVEN SUPPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLI
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGELHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-253-7764
Mailing Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2915
Mailing Address - Country:US
Mailing Address - Phone:651-253-7764
Mailing Address - Fax:
Practice Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2915
Practice Address - Country:US
Practice Address - Phone:651-253-7764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty