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General NPI Number Information
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NPI Number | 1518387034
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 3331 DUKE STREET
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City | ALEXANDRIA
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State | VA
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Zip | 22314
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Country | US
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Telephone | 202-596-6640
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Fax |
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Provider Business Mailing Address
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Address Line | 11409 FORT SARATOGA COURT
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City | FORT WASHINGTON
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State | MD
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Zip | 20744
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Country | US
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Telephone | 202-596-6640
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | RACHEL SCHUCHART
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Credential | PSYD
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Telephone | 202-596-6640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810004090
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License Number State | VA
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