NPIMap

Organization Active NPI

Haven Behavioral

  • Behavior Analyst
  • Colorado Springs, CO
National Provider Identifier
1770995011
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0-14-5932 Issued in IL
Legal business name
HAVEN BEHAVIORAL
Practice address
1330 Quail Lake Loop
Suite 240
Colorado Springs, CO 80906-4651
Phone
(719) 640-5445
NPI assigned
May 21, 2014
Last updated
May 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Authorized official

Name
Kirk McConnell
Title
VP
Phone
(719) 640-5445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0-14-5932 IL Primary

Addresses

Primary practice location

1330 Quail Lake Loop
Suite 240
Colorado Springs, CO 80906-4651

Mailing address

9420 S Avers Ave
Evergreen Park, IL 60805-2007
Phone (708) 285-0578

National Provider Directory

National Provider Directory

Locations

1330 Quail Lake Loop
Ste 240
Colorado Springs, CO 80906
Phone (719) 640-5445

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1770995011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 S AVERS AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052007",
            "telephone_number": "708-285-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 QUAIL LAKE LOOP",
            "address_2": "SUITE 240",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064651",
            "telephone_number": "719-640-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN BEHAVIORAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "719-640-5445"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "0-14-5932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.