Haven Mind Body Collective, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

HAVEN MIND BODY COLLECTIVE, LLC

Practice address

1105 15TH Ave Ste F
Longview, WA 98632-3080

Phone

(360) 703-6499

NPI assigned

Apr 8, 2024

Organization subpart

No

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

Authorized official

Name

Amanda Renee Hart, CCNPI 1164699013

Title

Certified Counselor

Phone

(360) 562-5509

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Amanda Renee Hart, CC, LMT

  • Mental Health Counselor
  • Longview, WA
  • NPI 1164699013
  NPD Authorized official

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1184477507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 15TH AVE STE F",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323080",
            "telephone_number": "360-703-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 15TH AVE STE F",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323080",
            "telephone_number": "360-703-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MIND BODY COLLECTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-06",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CERTIFIED COUNSELOR",
        "authorized_official_telephone_number": "360-562-5509",
        "authorized_official_credential": "CC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Renee Hart, CC, LMT
• Nicole Elaine Harvill, RN
• Laura Mae Hathaway
• Susan E Hather, CDPT
• Mark Thomas Hattenhauer, MD
• Ashley N Hawkes, ARNP
• David Norman Hawkins, CDP
• Diane C Hawkins, ARNP
• Wendi C Hawley, MA, ART-BC
• Betty L Hayes, MAC

• Mental Health Counselor in Longview, WA
• Providers in Longview, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.