Individual provider Active NPI

Jennifer R Havens, LPC

  • Professional Counselor
  • Mountain City, TN
National Provider Identifier
1780189647
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
332 Hospital Rd
Mountain City, TN 37683-4309
Phone
(423) 528-1535
NPI assigned
Mar 23, 2018
Last updated
Mar 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Specialties & licenses 3

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

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

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1780189647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 HOSPITAL RD",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376834309",
            "telephone_number": "423-528-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 HOSPITAL RD",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376834309",
            "telephone_number": "423-528-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.