Organization Active NPI

Inner Haven Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
National Provider Identifier
1225780422
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INNER HAVEN WELLNESS LLC
Practice address
401 Charmany Dr Ste 320
Madison, WI 53719-1270
Phone
(608) 982-0822
Fax
(608) 982-0842
NPI assigned
Jan 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Authorized official

Name
Vanessa Acevedo
Title
Director of Revenue Cycle
Phone
(305) 323-9332

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

401 Charmany Dr Ste 320
Madison, WI 53719-1270

Mailing address

3692 Grand Ave # 583
Miami, FL 33133-4953
Phone (608) 982-0822

Other practice location 1

19601 W Bluemound Rd Ste 200
Brookfield, WI 53045-5974
Phone (608) 982-0822

Other practice location 2

1504 S Commercial St
Neenah, WI 54956-4802
Phone (608) 982-0822

Other identifiers 1

IdentifierTypeStateIssuer
100204138MedicaidWI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2301471Inner Haven Wellness401 Charmany Dr Suite 320, Madison, WI 53719Certificate of waiverMar 25, 2028
52D2308314Inner Haven Wellness1504 S Commercial St, Neenah, WI 54956Certificate of waiverJul 24, 2028
52D2336898Inner Haven Wellness19601 W Bluemound Rd Suite 200, Brookfield, WI 53045Certificate of waiverJan 12, 2028

National Provider Directory

National Provider Directory

Locations

3692 Grand Ave
#583
Miami, FL 33133

19601 W Bluemound Rd
Ste 200
Brookfield, WI 53045
Phone (608) 982-0822

401 Charmany Dr
Madison, WI 53719

401 Charmany Dr
Ste 320
Madison, WI 53719
Phone (608) 400-1951

1504 S Commercial St
Neenah, WI 54956
Phone (920) 729-6088

300 N 3rd St
Ste 112
Watertown, WI 53094
Phone (920) 545-4357

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1225780422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3692 GRAND AVE # 583",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334953",
            "telephone_number": "608-982-0822",
            "fax_number": "608-982-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CHARMANY DR STE 320",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191270",
            "telephone_number": "608-982-0822",
            "fax_number": "608-982-0842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19601 W Bluemound Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530455974",
            "country_code": "US",
            "telephone_number": "608-982-0822",
            "fax_number": "608-982-0842",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1504 S Commercial St",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549564802",
            "country_code": "US",
            "telephone_number": "608-982-0822",
            "fax_number": "608-982-0842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNER HAVEN WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "305-323-9332"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100204138",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.