Haven, Kendra Lauren

Haven, Kendra Lauren is an sole proprietor health care provider with primary practice located at 7 Route 25A , Smithtown NY 11787-1626. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Haven, Kendra Lauren can be contacted via phone (631) 724-2200.

Contact Information

Primary practice address
7 Route 25A Smithtown NY 11787-1626
Phone: (631) 724-2200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 008198 New York
Behavioral Health & Social Service Providers / Clinical 103TC0700X 008198 New York

Profile Details

NPI number 1205939493
LBN Legal business name Haven, Kendra Lauren
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2006
Last updated Jun 2nd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205939493 NPPES
New York MEDICAID 00906487

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