Organization
M SHANNON ENTERPRISES
Active
Other names
Healing Haven Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE SELL (ADMINISTRATOR)
(310) 993-1329
Entity
Organization
Contact information
Practice address
6900 HOUSTON RD STE 12, FLORENCE, KY 41042-4891
(310) 619-8989
Mailing address
4375 RIVER RD, HEBRON, KY 41048-9720
(310) 619-8989
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366181539
—
KY
Enumeration date
06/03/2022
Last updated
05/26/2023
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