The Haven Wellness Center LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

THE HAVEN WELLNESS CENTER LLC

Practice address

4310 Gaston Ave Ste 200
Dallas, TX 75246-1312

Phone

(214) 535-8374

NPI assigned

Jan 2, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessica L Brazeal, LPC-S

Title

Co-Owner and Therapist

Phone

(214) 535-8374

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1033989074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 GASTON AVE STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461312",
            "telephone_number": "214-535-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 GASTON AVE STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461312",
            "telephone_number": "214-535-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HAVEN WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "BRAZEAL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CO-OWNER AND THERAPIST",
        "authorized_official_telephone_number": "214-535-8374",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.