Haven Mental Wellness PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

HAVEN MENTAL WELLNESS PLLC

Practice address

111 S Road St
Elizabeth City, NC 27909-4355

Phone

(252) 619-2309

NPI assigned

Sep 30, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Gemini J Johnson, LCSWNPI 1316197031

Title

Owner

Phone

(252) 619-2309

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gemini Jewel Johnson, MSW, LCSW

  • Clinical Social Worker
  • Elizabeth City, NC
  • NPI 1316197031
  NPD Authorized official

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1104598838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 W EHRINGHAUS ST STE 154",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094555",
            "telephone_number": "252-619-2309",
            "fax_number": "883-287-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094355",
            "telephone_number": "252-619-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MENTAL WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GEMINI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-619-2309",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "geminijohnsonLCSW@hushmail.com",
            "affiliation": "N",
            "address_1": "1142 N Road St",
            "city": "Elizabeth City",
            "state": "NC",
            "country_code": "US",
            "postal_code": "279093353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa L Harris, LPTA
• Nicholas M Hartman, CRNA
• Tianna Haskett
• Shanna Carti' Hassell, HS(HEALTH SERV.TECH)
• Haven House Counseling Collective, PLLC
• Lushell Hayes, FNP
• Healthcore Resource Inc
• Healthcore Resource, Inc
• Healthkeeperz, Inc
• Edward James Healy, PAC

• Clinical Social Worker in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.