Organization
CHILDREN'S HAVEN COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MONICA LYNN RANDOLPH AUVENSHINE MA, LPC (LICENSED PROFESSIONAL COUNSELOR/OWN)
(817) 446-5591
Entity
Organization
Contact information
Practice address
4200 SOUTH FWY STE 604, FORT WORTH, TX 76115-1402
(817) 446-5591
(817) 446-5591
Mailing address
PO BOX 24511, FORT WORTH, TX 76124-1511
(817) 446-5591
(817) 446-5591
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
19708
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659549137
—
TX
Enumeration date
05/06/2008
Last updated
05/06/2008
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