1982741450 NPI number — SAFE HARBOR CHRISTIAN COUNSELING

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982741450 NPI number — SAFE HARBOR CHRISTIAN COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAFE HARBOR CHRISTIAN COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982741450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2227 OLD EMMORTON ROAD
Provider Second Line Business Mailing Address:
SUITE 119
Provider Business Mailing Address City Name:
BEL AIR
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-893-4600
Provider Business Mailing Address Fax Number:
410-569-0094

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2122 W JOPPA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUTHERVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093-4701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-893-4600
Provider Business Practice Location Address Fax Number:
410-569-0094
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PERLIN
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
COUNSELOR
Authorized Official Telephone Number:
410-893-4600

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  12759 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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