Healthcare Provider Details

I. General information

NPI: 1073752069
Provider Name (Legal Business Name): SAFE HARBOR CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6427 FRANCONIA RD
SPRINGFIELD VA
22150-1210
US

IV. Provider business mailing address

2227 OLD EMMORTON RD 119
BEL AIR MD
21015-6187
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: ERIK SUNDQUIST
Title or Position: DIRECTOR
Credential: LCSW-C
Phone: 410-893-4600