# SERENITY HAVEN RECOVERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902663172
- **Authorized official:** MR. MELISSA ANN GOYEN LQMHP, LCAS, CCS-I (OWNER/CEO)
- **Authorized official phone:** (336) 402-1527

## Contact information

- **Practice address:** 4734 LIDDELL SHORTCUT RD, SEVEN SPRINGS, NC 28578-9469
- **Practice address phone:** (336) 402-1527
- **Mailing address:** 4734 LIDDELL SHORTCUT RD, SEVEN SPRINGS, NC 28578-9469
- **Mailing address phone:** (336) 402-1527

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |

## Other

- **Enumeration date:** 03/04/2024
- **Last updated:** 03/04/2024