Provider Demographics
NPI:1871117499
Name:HAVEN PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:HAVEN PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOUHAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZZOUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-910-8822
Mailing Address - Street 1:25 TERRELL RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-3428
Mailing Address - Country:US
Mailing Address - Phone:732-910-8822
Mailing Address - Fax:
Practice Address - Street 1:25 TERRELL RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08530-3428
Practice Address - Country:US
Practice Address - Phone:732-910-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty