Organization Active NPI

Safe Harbor Psychiatry LLC

  • Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1033818653
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SAFE HARBOR PSYCHIATRY LLC
Practice address
6280 E Pima St Ste 110
Tucson, AZ 85712-3074
Phone
(520) 298-7748
Fax
(520) 300-7363
NPI assigned
Mar 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William R Reynolds, PA-CNPI 1891844619
Title
Practioner/Owner
Phone
(520) 488-1776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

6280 E Pima St Ste 110
Tucson, AZ 85712-3074

Mailing address

PO Box 733
Marana, AZ 85653-0733
Phone (520) 490-4956

Other identifiers 1

IdentifierTypeStateIssuer
737379MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1033818653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530733",
            "telephone_number": "520-490-4956",
            "fax_number": "520-300-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 E PIMA ST STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123074",
            "telephone_number": "520-298-7748",
            "fax_number": "520-300-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTIONER/OWNER",
        "authorized_official_telephone_number": "520-488-1776",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "737379",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.