Healthcare Provider Details

I. General information

NPI: 1780201442
Provider Name (Legal Business Name): SAFE HARBOR MENTAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 UPTOWN SQ
MURFREESBORO TN
37129-0589
US

IV. Provider business mailing address

PO BOX 10393
MURFREESBORO TN
37129-0008
US

V. Phone/Fax

Practice location:
  • Phone: 615-624-8342
  • Fax: 615-603-7612
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TAMMY CYR
Title or Position: MEMBER
Credential: PMHNP-BC
Phone: 931-581-1502