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HEALING HAVEN LICENSED CLINICAL
NPI 1144046608
Social Worker - Clinical in San Jacinto, CA

Active since December 02, 2024
315 E ESPLANADE AVE UNIT 89, SAN JACINTO, CA 92583(951) 214-5071 Get Directions Write a Review

NPPES record last updated: March 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2025, Dec 2, 2024 (2 updates tracked since 2024).

About Healing Haven Licensed Clinical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEALING HAVEN LICENSED CLINICAL (NPI 1144046608) is a healthcare organization registered as a clinical in San Jacinto, California and active in the NPI registry since December 2024. The organization lists Kenyada M Wagoner, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1144046608
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameHEALING HAVEN LICENSED CLINICAL
Location Address315 E ESPLANADE AVE UNIT 89San Jacinto, CA 92583-5102
Mailing Address315 E Esplanade Ave Unit 89San Jacinto, CA 92583-5102 · (951) 214-5071
Phone(951) 214-5071
Organization SubpartNo
Authorized OfficialKenyada M WagonerOwner/ceo · (951) 214-5071
Enumeration DateDecember 2, 2024
Last NPPES UpdateMarch 20, 20252 updates tracked since enumeration
NPPES CertifiedMarch 20, 2025
✔ NPI 1144046608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
315 E ESPLANADE AVE UNIT 89, San Jacinto, CA 92583
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Healing Haven Licensed Clinical's NPI number?

The NPI number for Healing Haven Licensed Clinical is 1144046608. It was assigned to this organization in the NPPES registry on December 2, 2024.

Where is Healing Haven Licensed Clinical located?

Healing Haven Licensed Clinical is located at 315 E Esplanade Ave Unit 89, San Jacinto, CA 92583. The listed phone number is (951) 214-5071.

What is Healing Haven Licensed Clinical's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Healing Haven Licensed Clinical was last updated on March 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.