Organization
HAVEN YOUTH AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLEY SMITH LCSW (DIRECTOR)
(847) 251-6630
Entity
Organization
Contact information
Practice address
825 GREEN BAY RD, SUITE 200, WILMETTE, IL 60091-2597
(847) 251-6630
(815) 521-1889
Mailing address
PO BOX 613, CHANNAHON, IL 60410-0613
(815) 521-1889
(815) 521-1889
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
149013375
IL
1041C0700X
Clinical Social Worker
—
IL
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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