The Haven Collective

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114084 Issued in MA

Legal business name

THE HAVEN COLLECTIVE

Practice address

288 Walnut St
Suite 412
Newton, MA 02460-1948

Phone

(617) 552-5116

NPI assigned

Feb 5, 2016

Organization subpart

No

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

Authorized official

Name

Haven Fyfe Kiernan, LICSW

Title

Owner

Phone

(617) 552-5116

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1982062865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 WALNUT ST",
            "address_2": "SUITE 412",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024601948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 WALNUT ST",
            "address_2": "SUITE 412",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024601948",
            "telephone_number": "617-552-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HAVEN COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "FYFE KIERNAN",
        "authorized_official_first_name": "HAVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-552-5116",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Newton, MA
• Providers in Newton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.