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Organization
HAVEN THERAPY AND WELLNESS PLLC
Active
Organization
HAVEN THERAPY AND WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA LANE LCSW (LCSW)
(312) 248-4460
Entity
Organization
Contact information
Practice address
1623 N WESTERN AVE, CHICAGO, IL 60647-5321
(312) 248-4660
Mailing address
1623 N WESTERN AVE, CHICAGO, IL 60647-5321
(312) 248-4660
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
01/05/2024
Last updated
05/14/2025
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