| Haven Mental Wellness Pllc | |
|
1142 N Road St Elizabeth City NC 27909-3353 | |
| (252) 619-2309 | |
| Not Available |
| Full Name | Haven Mental Wellness Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1142 N Road St, Elizabeth City, North Carolina |
| Authorized Official Name and Position | Gemini J Johnson (OWNER) |
| Authorized Official Contact | 2526192309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Haven Mental Wellness Pllc 110 Medical Dr Ste 3 Elizabeth City NC 27909-3374 Ph: (252) 619-2309 | Haven Mental Wellness Pllc 1142 N Road St Elizabeth City NC 27909-3353 Ph: (252) 619-2309 |
| NPI Number | 1104598838 |
|---|---|
| Provider Enumeration Date | 09/30/2021 |
| Last Update Date | 01/18/2022 |
| Certification Date | 01/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104598838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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