Active NPI
Robert W. Dehaven, M.S., NCC, LPC, DAPA
- Mental Health Counselor
- Hazlehurst, GA
National Provider Identifier
1023079555
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective May 20, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC003880
- Practice address
- 121 Ray Rd
Hazlehurst, GA 31539-5119 - Phone
- (478) 296-9394
- Fax
- (478) 296-9394
- NPI assigned
- Apr 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC003880 | GA | Primary |
| Professional Counselor | 101YP2500X | LPC003880 | GA |
Addresses
Primary practice location
121 Ray Rd
Hazlehurst, GA 31539-5119
Mailing address
121 Ray Rd
Hazlehurst, GA 31539-5119
Phone (478) 296-9394
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11367944 | Other | GA | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC003880 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1023079555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 RAY RD",
"city": "HAZLEHURST",
"state": "GA",
"postal_code": "315395119",
"telephone_number": "478-296-9394",
"fax_number": "478-296-9394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 RAY RD",
"city": "HAZLEHURST",
"state": "GA",
"postal_code": "315395119",
"telephone_number": "478-296-9394",
"fax_number": "478-296-9394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHAVEN",
"first_name": "ROBERT",
"middle_name": "W.",
"name_prefix": "Mr.",
"credential": "M.S., NCC, LPC, DAPA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-02",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC003880",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC003880",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11367944",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hazlehurst, GA
- CRH Physician Practices, LLC (CRH Hazelhurst Group)
- David J. Ellis, DO, LLC
- David L Turfler MD PC
- Christina Gail Davis, PTA
- Dehaven Healthcare, Inc.
- Dr. Jason R Laney, PC (Laney Internal Medicine Group)
- Elizabeth Sha Duque, APRN
- DZH, Inc (Therapy Services of Georgia)
- East Georgia Healthcare Center, Inc.
- Megan Marchant East, SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.