Jennifer R Havens, LPC

Individual provider Active NPI Professional Counselor · Mountain City, TN

NPI 1780189647 · NPPES record last updated Mar 23, 2018

Key facts

NPI
1780189647
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
332 Hospital Rd
Mountain City, TN 37683-4309
Phone
(423) 528-1535
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X TN
Mental Health Counselor 101YM0800X TN
Professional Counselor 101YP2500X TN Yes

Addresses

Primary practice location

332 Hospital Rd
Mountain City, TN 37683-4309

Mailing address

332 Hospital Rd
Mountain City, TN 37683-4309
Phone (423) 528-1535

Other providers in Mountain City, TN

All providers in Mountain City, TN · Professional Counselor in Tennessee

Sources for this page

Verify at the official NPI Registry.