Organization Active NPI

Safe Haven Counseling

  • Addiction (Substance Use Disorder) Psychologist
  • Hagerstown, MD
National Provider Identifier
1124149000
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
Legal business name
SAFE HAVEN COUNSELING
Practice address
111 W Washington St
Hagerstown, MD 21740-4709
Phone
(301) 766-7214
Fax
(410) 872-9169
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Jeannine Jackson
Title
President
Phone
(301) 766-7214

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X Primary

Addresses

Primary practice location

111 W Washington St
Hagerstown, MD 21740-4709

Mailing address

PO Box 743
Hagerstown, MD 21741-0743
Phone (410) 872-9188

National Provider Directory

National Provider Directory

Locations

111 W Washington St
Hagerstown, MD 21740
Phone (301) 766-7214

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1124149000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217410743",
            "telephone_number": "410-872-9188",
            "fax_number": "410-872-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404709",
            "telephone_number": "301-766-7214",
            "fax_number": "410-872-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-766-7214",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.