Provider Demographics
NPI:1942191697
Name:CHAOS HAVEN COUNSELING, LLC
Entity type:Organization
Organization Name:CHAOS HAVEN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, NCC
Authorized Official - Phone:270-634-9263
Mailing Address - Street 1:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-0762
Mailing Address - Country:US
Mailing Address - Phone:270-634-9263
Mailing Address - Fax:
Practice Address - Street 1:2556 CORBIN RICHARDS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-9426
Practice Address - Country:US
Practice Address - Phone:270-634-9263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty