Individual
MR. ROBERT W. DEHAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., NCC, LPC, DAPA
Contact information
Practice address
121 RAY RD, HAZLEHURST, GA 31539-5119
(478) 296-9394
(478) 296-9394
Mailing address
121 RAY RD, HAZLEHURST, GA 31539-5119
(478) 296-9394
(478) 296-9394
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC003880
GA
101YP2500X
Professional Counselor
LPC003880
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11367944
CAQH
GA
Enumeration date
04/02/2006
Last updated
09/11/2025
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