Jaclyn Anne Haven, MS, CGC – Genetic Counselor (M.S.)

Key facts

NPI: 1194118232
Entity type: Individual (NPI type 1)
Primary specialty: Genetic Counselor (M.S.) 170300000X
Practice address: 2755 Colonial Dr
Helena, MT 59601-4926
Phone: (406) 444-7520
Fax: (406) 444-1022
NPI assigned: Mar 13, 2015
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Montana Children'S Home & Hospital Clinical Medical Laboratory · Helena, MT · NPI 1053577205

NPD (past)
St Peter'S Medical Group North Family Medicine Physician · Helena, MT · NPI 1477844744

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Master of Science

Practice roles

Organization	Specialty	Status	New patients
St Peter'S Medical Group North		Past	Accepting new patients
Montana Children'S Home & Hospital		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Genetic Counselor (M.S.)	170300000X			Yes

Addresses

Primary practice location

2755 Colonial Dr
Helena, MT 59601-4926

Mailing address

2755 Colonial Dr
Helena, MT 59601-4926
Phone (406) 444-7520

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 20, 2016.

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1194118232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 COLONIAL DR",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014926",
            "telephone_number": "406-444-7520",
            "fax_number": "406-444-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 COLONIAL DR",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014926",
            "telephone_number": "406-444-7520",
            "fax_number": "406-444-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVEN",
        "first_name": "JACLYN",
        "middle_name": "ANNE",
        "credential": "MS, CGC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-13",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

All providers in Helena, MT · Genetic Counselor (M.S.) in Montana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.