NPIMap

Organization Active NPI

Bethel Haven, Inc

  • Mental Health Counselor
  • Watkinsville, GA
National Provider Identifier
1346574134
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BETHEL HAVEN, INC
Practice address
1030 Village Dr Ste B
Watkinsville, GA 30677-6004
Phone
(706) 310-9046
Fax
(706) 310-9076
NPI assigned
Sep 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Authorized official

Name
Diane Brantley
Title
Executive Director
Phone
(706) 310-9046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1030 Village Dr Ste B
Watkinsville, GA 30677-6004

Mailing address

1030 Village Dr Ste B
Watkinsville, GA 30677-6004
Phone (706) 310-9046

National Provider Directory

National Provider Directory
Tax ID family
Bethel Haven Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1030 Village Dr
#B
Watkinsville, GA 30677
Phone (706) 310-9046

NPI Registry JSON

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1346574134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 VILLAGE DR STE B",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306776004",
            "telephone_number": "706-310-9046",
            "fax_number": "706-310-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 VILLAGE DR STE B",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306776004",
            "telephone_number": "706-310-9046",
            "fax_number": "706-310-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL HAVEN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-25",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "706-310-9046"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.