Organization Active NPI

Safe Harbor Haven Inc.

Doing business as Safe Harbor Boys Home

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1578807400
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH5256 Issued in FL
Legal business name
SAFE HARBOR HAVEN INC.
Doing business as
Safe Harbor Boys Home
Practice address
4772 Safe Harbor Way
Jacksonville, FL 32226-4024
Phone
(904) 757-7918
Fax
(904) 757-2504
NPI assigned
Nov 15, 2012
Last updated
Nov 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
Mrs. Robbie Smith, LMHC
Title
Clinical Director
Phone
(904) 757-7918

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH5256 FL Primary

Addresses

Primary practice location

4772 Safe Harbor Way
Jacksonville, FL 32226-4024

Mailing address

4772 Safe Harbor Way
Jacksonville, FL 32226-4024
Phone (904) 757-7918

Other names 1

  • Safe Harbor Boys Home Doing business as

National Provider Directory

National Provider Directory

Locations

4772 Safe Harbor Way
Jacksonville, FL 32226
Phone (904) 757-7918

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1578807400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4772 SAFE HARBOR WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322264024",
            "telephone_number": "904-757-7918",
            "fax_number": "904-757-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 SAFE HARBOR WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322264024",
            "telephone_number": "904-757-7918",
            "fax_number": "904-757-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR HAVEN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBBIE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "904-757-7918",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safe Harbor Boys Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.