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General NPI Number Information
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NPI Number | 1871358093
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR COUNSELING OF MISSOURI, LLC
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 3106 PEARL HARBOR DR
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City | SAINT ANN
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State | MO
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Zip | 63074-3809
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Country | US
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Telephone | 314-704-2541
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Fax |
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Provider Business Mailing Address
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Address Line | 3106 PEARL HARBOR DR
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City | SAINT ANN
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State | MO
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Zip | 63074-3809
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Country | US
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Telephone | 314-704-2541
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Fax |
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Authorized Official
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Title or Position | OWNER / LEAD THERAPIST
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Name | MR. MICHAEL MASON
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Credential | M.ED. LPC, NCC
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Telephone | 314-704-2541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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