Active NPI
Inner Haven Wellness LLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Madison, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100204138 | Medicaid | WI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2301471 | Inner Haven Wellness | Certificate of waiver | Mar 25, 2028 |
| 52D2308314 | Inner Haven Wellness | Certificate of waiver | Jul 24, 2028 |
| 52D2336898 | Inner Haven Wellness | Certificate of waiver | Jan 12, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Mental Health Counselor
- Watertown, WI
- NPI 1962913012
-
- Mental Health Counselor
- Watertown, WI
- NPI 1497644157
-
- Mental Health Counselor
- Brookfield, WI
- NPI 1689451593
-
- Professional Counselor
- Sussex, WI
- NPI 1518697242
-
- Professional Counselor
- Watertown, WI
- NPI 1629695671
-
- Mental Health Counselor
- Watertown, WI
- NPI 1306575972
-
- Clinical Social Worker
- Watertown, WI
- NPI 1710713342
-
- Professional Counselor
- Watertown, WI
- NPI 1558240556
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.