Mind Haven LLC

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

MIND HAVEN LLC

Practice address

1561 Bramlett Hill LN
Lawrenceville, GA 30045-2601

Phone

(843) 364-4374

NPI assigned

Oct 18, 2022

Organization subpart

No

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

Authorized official

Name

Shonta Williams, MA

Title

Mental Health Counselor

Phone

(843) 364-4374

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1427774629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 BRAMLETT HILL LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300452601",
            "telephone_number": "843-364-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 BRAMLETT HILL LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300452601",
            "telephone_number": "843-364-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHONTA",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "843-364-4374",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Miller, MA, LPC
• Tamara Bethany Miller, LCSW
• Nicole Harris Mills, LPC
• Catherine Milum, RDN, LD
• William Min, MD
• Mindful Faith Psychiatry Care LLC
• Minding My Health Solutions LLC
• Carolyn M Minor, LCSW
• Makeda Minott
• Opal Hope Minott, LCSW

• Public Health or Welfare Agency in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Public Health or Welfare Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.