NPIMap

Organization Active NPI

Havens of Minnesota LLC

  • Addiction (Substance Use Disorder) Counselor
  • Shakopee, MN
National Provider Identifier
1134837610
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
HAVENS OF MINNESOTA LLC
Practice address
235 1St Ave E
Shakopee, MN 55379-1440
Phone
(952) 496-3366
NPI assigned
Nov 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Tedd Herman
Title
Ceo
Phone
(612) 895-4605

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

235 1St Ave E
Shakopee, MN 55379-1440

Mailing address

2101 Wooddale Dr Ste B
Woodbury, MN 55125-4442
Phone (651) 734-9633

Other names 1

  • The Haven in Shakopee Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Havens of Minnesota LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1134837610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE B",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254442",
            "telephone_number": "651-734-9633",
            "fax_number": "651-734-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791440",
            "telephone_number": "952-496-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENS OF MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "TEDD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-895-4605"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Haven in Shakopee",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Haven in Shakopee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.