NPIMap

Organization Active NPI

Harbor

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Toledo, OH
National Provider Identifier
1366526782
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
240 Issued in OH
Legal business name
HARBOR
Practice address
3909 Woodley Rd
Toledo, OH 43606-1169
Phone
(419) 725-3330
NPI assigned
Oct 24, 2006
Last updated
Sep 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Dustin Watkins
Title
President/Ceo
Phone
(567) 343-0947

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 240 OH Primary
Counselor 101Y00000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Professional Counselor 101YP2500X NU
Clinical Neuropsychologist 103G00000X NU
Clinical Psychologist 103TC0700X NU
Counseling Psychologist 103TC1900X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Family Medicine Physician 207Q00000X NU
Developmental - Behavioral Pediatrics Physician 2080P0006X NU
Psychiatry Physician 2084P0800X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU
Geriatric Psychiatry Physician 2084P0805X NU

Addresses

Primary practice location

3909 Woodley Rd
Toledo, OH 43606-1169

Mailing address

3909 Woodley Rd
Toledo, OH 43606-1169

Other practice location 1

800 Commerce Dr
Perrysburg, OH 43551-5256
Phone (419) 872-2419

Other practice location 2

123 22nd St
Toledo, OH 43604-2706
Phone (419) 241-6191

Other practice location 3

7140 Port Sylvania Dr
Toledo, OH 43617-1176
Phone (567) 408-7242

Other practice location 4

1010 N Prospect St
Bowling Green, OH 43402-1335
Phone (419) 352-5387

Other practice location 5

97 Houpt Dr
Upper Sandusky, OH 43351-8904
Phone (419) 731-0720

Other practice location 6

4334 Secor Rd
Toledo, OH 43623-4234
Phone (419) 475-4449

Other practice location 7

127 Blakeslee Ave
Bryan, OH 43506-1692
Phone (567) 239-4171

Other practice location 8

1033 Devlac Grv
Bowling Green, OH 43402-4501
Phone (419) 352-6460

Other practice location 9

101 Clinton St
Defiance, OH 43512-2176
Phone (419) 782-4196

Other identifiers 6

IdentifierTypeStateIssuer
110754-000OtherMAGELLAN
3126MedicaidOH
01927OtherPARAMOUNT HEALTH CARE
060172OtherVALUE OPTIONS
2341639MedicaidOH
611706700OtherDOL FECA

Other names 1

  • Harbor Behavioral Healthcare Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000276 OH Part B Supplier - Clinic/Group Practice 8325931181 Receives reassigned benefits from 96 practitioners
Practice locations: Bowling Green, OH; Defiance, OH; Perrysburg, OH; Toledo, OH

National Provider Directory

National Provider Directory
Tax ID family
Harbor3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

  • Harbor
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Toledo, OH
    • NPI 1770741803
    NPD tax ID
  • Harbor
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Toledo, OH
    • NPI 1932510385
    NPD tax ID

Locations

5300 Harroun Rd
Ste 120
Sylvania, OH 43560
Phone (419) 536-0616

123 22nd St
Toledo, OH 43604
Phone (419) 241-6191

Practitioners & affiliated clinicians

Practitioners 251

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.

View all 251

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1366526782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169",
            "telephone_number": "419-725-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Perrysburg",
            "state": "OH",
            "postal_code": "435515256",
            "country_code": "US",
            "telephone_number": "419-872-2419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 22nd St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436042706",
            "country_code": "US",
            "telephone_number": "419-241-6191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7140 Port Sylvania Dr",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436171176",
            "country_code": "US",
            "telephone_number": "567-408-7242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 N Prospect St",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "OH",
            "postal_code": "434021335",
            "country_code": "US",
            "telephone_number": "419-352-5387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 Houpt Dr",
            "address_purpose": "LOCATION",
            "city": "Upper Sandusky",
            "state": "OH",
            "postal_code": "433518904",
            "country_code": "US",
            "telephone_number": "419-731-0720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4334 Secor Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436234234",
            "country_code": "US",
            "telephone_number": "419-475-4449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 Blakeslee Ave",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "OH",
            "postal_code": "435061692",
            "country_code": "US",
            "telephone_number": "567-239-4171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1033 Devlac Grv",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "OH",
            "postal_code": "434024501",
            "country_code": "US",
            "telephone_number": "419-352-6460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Clinton St",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435122176",
            "country_code": "US",
            "telephone_number": "419-782-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HARBOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "567-343-0947"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OH",
            "license": "240",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "110754-000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3126",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT HEALTH CARE",
            "identifier": "01927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "060172",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2341639",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL FECA",
            "identifier": "611706700",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor Behavioral Healthcare",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Harbor Behavioral Healthcare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.