Provider Demographics
NPI:1871206748
Name:HAVEN BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:HAVEN BEHAVIORAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-868-7677
Mailing Address - Street 1:2301 S BAGDAD RD STE 404D
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2309
Mailing Address - Country:US
Mailing Address - Phone:512-868-7677
Mailing Address - Fax:
Practice Address - Street 1:2301 S BAGDAD RD STE 404D
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2309
Practice Address - Country:US
Practice Address - Phone:512-868-7677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty