NPIMap

Organization Active NPI

Safe Harbor Christian Counseling of New Jersey LLC

  • Professional Counselor
  • Mountainside, NJ
National Provider Identifier
1215388178
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SAFE HARBOR CHRISTIAN COUNSELING OF NEW JERSEY LLC
Practice address
200 Central Ave
Suite 100
Mountainside, NJ 07092-1926
Phone
(410) 893-4600
Fax
(443) 640-4358
NPI assigned
Jun 22, 2016
Last updated
Jun 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Shelly Yost
Title
Regional Director
Phone
(410) 893-4600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

200 Central Ave
Suite 100
Mountainside, NJ 07092-1926

Mailing address

2208 Mountain Ave
Scotch Plains, NJ 07076-1304

National Provider Directory

National Provider Directory

Locations

200 Central Ave
Ste 100
Mountainside, NJ 07092

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1215388178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 MOUNTAIN AVE",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070761304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070921926",
            "telephone_number": "410-893-4600",
            "fax_number": "443-640-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR CHRISTIAN COUNSELING OF NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "YOST",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "410-893-4600"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.