Organization
IVY HAVEN COUNSELING AND CONSULTING LLC
Active
Organization
IVY HAVEN COUNSELING AND CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONTA WILLIAMS (MENTAL HEALTH COUNSELOR)
(843) 364-4374
Entity
Organization
Contact information
Practice address
1561 BRAMLETT HILL LN, LAWRENCEVILLE, GA 30045-2601
(843) 364-4374
Mailing address
1561 BRAMLETT HILL LN, LAWRENCEVILLE, GA 30045-2601
(843) 364-4374
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
07/11/2021
Last updated
07/11/2021
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