NPIMap

Organization Active NPI

Haven Behavioral Health, LLC

  • Social Worker
  • Forked River, NJ
National Provider Identifier
1740812106
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
HAVEN BEHAVIORAL HEALTH, LLC
Practice address
500 North Main Street
Forked River, NJ 08734-4831
Phone
(732) 470-8270
NPI assigned
Feb 4, 2020
Last updated
Feb 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Authorized official

Name
Mrs. Zahara AmoyelleNPI 1447134002
Title
Member
Phone
(732) 470-8270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X NU
Social Worker 104100000X NU Primary
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

500 North Main Street
Forked River, NJ 08734-4831

Mailing address

4 Garden Ter
Lakewood, NJ 08701-3768
Phone (732) 470-8270

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL zamoyelle@havenbehavioralhealth.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200303000934 NJ Part B Supplier - Clinic/Group Practice 9234566241 Receives reassigned benefits from 5 practitioners
Practice locations: Forked River, NJ; Lanoka Harbor, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1740812106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GARDEN TER",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013768",
            "telephone_number": "732-470-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NORTH MAIN STREET",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087344831",
            "telephone_number": "732-470-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "AMOYELLE",
        "authorized_official_first_name": "ZAHARA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-470-8270",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "zamoyelle@havenbehavioralhealth.org",
            "affiliation": "N",
            "endpointDescription": "HIPAA email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIPAA compliant email",
            "address_1": "500 North Main Street",
            "city": "Forked River",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087344831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Forked River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.