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General NPI Number Information
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NPI Number | 1215308564
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR CHRISTIAN COUNSELING
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 5110 FREDERICK AVE
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City | BALTIMORE
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State | MD
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Zip | 21229-3218
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Country | US
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Telephone | 410-893-4600
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Fax | 443-640-4358
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Provider Business Mailing Address
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Address Line | 1208 E CHURCHVILLE RD
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City | BEL AIR
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State | MD
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Zip | 21014-3442
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Country | US
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Telephone | 410-893-4600
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Fax | 443-640-4358
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Authorized Official
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Title or Position | NATIONAL DIRECTOR
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Name | ERIK SUNDQUIST
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Credential |
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Telephone | 410-893-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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