NPIMap

Organization Active NPI

Haven Ministries, Inc.

  • Child & Adolescent Psychiatry Physician
  • Lake Waccamaw, NC
National Provider Identifier
1992019335
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
200301378 Issued in NC
Legal business name
HAVEN MINISTRIES, INC.
Practice address
107 Church St
Lake Waccamaw, NC 28450-1909
Phone
(910) 803-1620
Fax
(215) 902-4882
NPI assigned
Jul 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Authorized official

Name
Dr. Dwight Howard Lysne, MD,MDIV
Title
Director
Phone
(910) 803-1620

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X 200301378 NC
Addiction Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0802X 200301378 NC
Child & Adolescent Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0804X 200301378 NC Primary

Addresses

Primary practice location

107 Church St
Lake Waccamaw, NC 28450-1909

Mailing address

7212 Oyster LN
Wilmington, NC 28411-7132
Phone (910) 803-1620

National Provider Directory

National Provider Directory
Tax ID family
Haven Ministries Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1992019335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 OYSTER LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284117132",
            "telephone_number": "910-803-1620",
            "fax_number": "215-902-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CHURCH ST",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284501909",
            "telephone_number": "910-803-1620",
            "fax_number": "215-902-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "LYSNE",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-803-1620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,MDIV"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200301378",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NC",
            "license": "200301378",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "200301378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Waccamaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.