Organization Active NPI

Haven Counseling Collective LLC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1851039648
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HAVEN COUNSELING COLLECTIVE LLC
Practice address
4424 NE Glisan St Ste 22
Portland, OR 97213-2331
Phone
(503) 505-1408
Fax
(503) 437-9771
NPI assigned
May 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Diana Latorre, LCSW, CADC III
Title
Clinical Director/ Owner
Phone
(503) 888-1309

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4424 NE Glisan St Ste 22
Portland, OR 97213-2331

Mailing address

4424 NE Glisan St Ste 22
Portland, OR 97213-2331
Phone (503) 888-1309

National Provider Directory

National Provider Directory

Locations

4424 NE Glisan St
Ste 7
Portland, OR 97213

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1851039648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 NE GLISAN ST STE 22",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132331",
            "telephone_number": "503-888-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 NE GLISAN ST STE 22",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132331",
            "telephone_number": "503-505-1408",
            "fax_number": "503-437-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN COUNSELING COLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "LATORRE",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/ OWNER",
        "authorized_official_telephone_number": "503-888-1309",
        "authorized_official_credential": "LCSW, CADC III"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.