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General NPI Number Information
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NPI Number | 1679201982
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR COUNSELING
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Dates
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Enumeration Date | 08/13/2022
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 560 W SUNNYSIDE RD STE D
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City | IDAHO FALLS
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State | ID
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Zip | 83402-4641
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Country | US
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Telephone | 208-274-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 1438 N 615 E
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City | SHELLEY
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State | ID
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Zip | 83274-5077
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Country | US
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Telephone | 801-510-7230
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JULIE CARLSON
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Credential | LCSW
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Telephone | 801-510-7230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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