Organization
HAVEN MENTAL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA LOUISE RUSSELL LCSW (OWNER)
(208) 610-6459
Entity
Organization
Contact information
Practice address
1317 PROMINENCE CT, SANDPOINT, ID 83864-5412
(208) 610-6459
(208) 610-6459
Mailing address
1317 PROMINENCE CT, SANDPOINT, ID 83864-5412
(208) 610-6459
(208) 610-6459
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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