Provider Demographics
NPI:1992098446
Name:SAFE HARBOR COUNSELING, INC
Entity type:Organization
Organization Name:SAFE HARBOR COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-669-5908
Mailing Address - Street 1:2692 US HIGHWAY I, SOUTH
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086
Mailing Address - Country:US
Mailing Address - Phone:904-669-5908
Mailing Address - Fax:904-794-4225
Practice Address - Street 1:2692 US HIGHWAY I, SOUTH
Practice Address - Street 2:SUITE 205
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086
Practice Address - Country:US
Practice Address - Phone:904-669-5908
Practice Address - Fax:904-794-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW704081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty