Healthcare Provider Details

I. General information

NPI: 1700923158
Provider Name (Legal Business Name): SAFE HARBOR CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 OLD EMMORTON RD SUITE 119
BEL AIR MD
21015
US

IV. Provider business mailing address

2227 OLD EMMORTON RD SUITE 119
BEL AIR MD
21015
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-4600
  • Fax: 410-569-0094
Mailing address:
  • Phone: 410-893-4600
  • Fax: 410-569-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC1699
License Number StateMD

VIII. Authorized Official

Name: VICTORIA SIMMONS-ELKINS
Title or Position: COUNSELOR
Credential: LCPC
Phone: 410-893-4600