Haven

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

200301378 Issued in NC

Legal business name

HAVEN

Practice address

20 S 16TH St
Wilmington, NC 28401-4924

Phone

(910) 399-3927

Fax

(910) 399-3928

NPI assigned

Jun 29, 2009

Organization subpart

No

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

Authorized official

Name

Dwight Lysne, M,D., DIV.

Title

Director

Phone

(910) 465-1935

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1285862292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014924",
            "telephone_number": "910-399-3927",
            "fax_number": "910-399-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014924",
            "telephone_number": "910-399-3927",
            "fax_number": "910-399-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "LYSNE",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-465-1935",
        "authorized_official_credential": "M,D., DIV."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "200301378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hisham Hatoum, MD, DDS
• Cody Haumann
• Megan Havel, MS, NCC, LPCA
• Nicole Havelka, CPM
• Haven
• Haven Ministries, Inc.
• Haven Ministries, Inc.
• Haven Ministries, Inc.
• Haven Ministries, Inc.
• Haven Ministries, Inc. @ Agape

• Child & Adolescent Psychiatry Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Child & Adolescent Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.