Havenrise Academy of Jacksonville, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

HAVENRISE ACADEMY OF JACKSONVILLE, LLC

Practice address

10550 Deerwood Park Blvd Ste 301
Jacksonville, FL 32256-2805

Phone

(904) 352-0682

NPI assigned

Jun 10, 2025

Organization subpart

Yes

Parent organization

HAVENRISE ACADEMY HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Jamie Stevens

Title

Ceo

Phone

(904) 993-1559

Specialties & licenses 1

Addresses

Part of

Havenrise Academy Holdings LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Havenrise Academy Holdings, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Jacksonville, FL
  • NPI 1427943828
  NPPES parent name

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1134014384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 DEERWOOD PARK BLVD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562805",
            "telephone_number": "904-352-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 DEERWOOD PARK BLVD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562805",
            "telephone_number": "904-352-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENRISE ACADEMY OF JACKSONVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVENRISE ACADEMY HOLDINGS, LLC",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-993-1559",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyse Hausman, PT, DPT
• Yajaira Hausman
• Have Faith Support Services
• Haven Home Care Inc
• Havenrise Academy Holdings, LLC
• Tammy Havey
• David Hawkins, PHD
• Diana Hawkins, PA-C
• John Clifford Hawkins III, MD
• Marissa R Hawkins, PT

• Adolescent and Children Mental Health Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.