NPIMap

Organization Active NPI

Havens of Minnesota LLC

Doing business as The Haven in Cloquet

  • Addiction (Substance Use Disorder) Counselor
  • Cloquet, MN
National Provider Identifier
1386352862
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
HAVENS OF MINNESOTA LLC
Doing business as
The Haven in Cloquet
Practice address
1003 Cloquet Ave Ste 117
Cloquet, MN 55720-1649
Phone
(218) 879-5545
NPI assigned
Nov 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Tedd Herman
Title
Ceo
Phone
(612) 895-4605

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

1003 Cloquet Ave Ste 117
Cloquet, MN 55720-1649

Mailing address

2101 Wooddale Dr Ste B
Woodbury, MN 55125-4442
Phone (651) 734-9633

Other names 1

  • The Haven in Cloquet Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL TBD

National Provider Directory

National Provider Directory
Tax ID family
Havens of Minnesota LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1003 Cloquet Ave
Ste 117
Cloquet, MN 55720
Phone (218) 879-5545

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1386352862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE B",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254442",
            "telephone_number": "651-734-9633",
            "fax_number": "651-734-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 CLOQUET AVE STE 117",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201649",
            "telephone_number": "218-879-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENS OF MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "TEDD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-895-4605"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "TBD",
            "affiliation": "N",
            "address_1": "1003 Cloquet Ave Ste 117",
            "city": "Cloquet",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557201649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Haven in Cloquet",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Haven in Cloquet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cloquet, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.