Organization Active NPI

Haven Mental Health & Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, SC
National Provider Identifier
1942056122
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HAVEN MENTAL HEALTH & WELLNESS
Practice address
3237 Emanuel Church Rd
Lexington, SC 29073-8940
Phone
(803) 694-7040
Fax
(803) 694-7038
NPI assigned
Apr 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Mr. James Russell Salyer III
Title
Registered Agent
Phone
(307) 871-2728

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3237 Emanuel Church Rd
Lexington, SC 29073-8940

Mailing address

1792 S Lake Dr Ste 90-235
Lexington, SC 29073-6824
Phone (803) 694-7040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240904001969 SC Part B Supplier - Clinic/Group Practice 3779023890 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, SC

National Provider Directory

National Provider Directory

Locations

1792 S Lake Dr
Ste 90235
Lexington, SC 29073

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1942056122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 S LAKE DR STE 90-235",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290736824",
            "telephone_number": "803-694-7040",
            "fax_number": "803-694-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 EMANUEL CHURCH RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290738940",
            "telephone_number": "803-694-7040",
            "fax_number": "803-694-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MENTAL HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-27",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "SALYER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "307-871-2728",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.