NPIMap

Organization Active NPI

Safe Harbor Behavioral Health of Upmc Hamot

  • Clinic/Center
  • Erie, PA
National Provider Identifier
1659133668
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAFE HARBOR BEHAVIORAL HEALTH OF UPMC HAMOT
Doing business as
UPMC Western Behavioral Health at Safe Harbor
Practice address
2556 W 12TH St
Erie, PA 16505-4508
Phone
(814) 835-2960
Fax
(814) 833-0879
NPI assigned
Jan 25, 2024
Organization subpart
Yes
Parent organization
UPMCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Mandy Ann Fauble
Title
Director Clinical Care Services
Phone
(814) 451-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2556 W 12TH St
Erie, PA 16505-4508

Mailing address

1330 W 26TH St
Erie, PA 16508-1402
Phone (814) 451-2232

Other identifiers 1

IdentifierTypeStateIssuer
455580OtherPASTATE LICENSE

Other names 1

  • UPMC Western Behavioral Health at Safe Harbor Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address safeharbor@upmcdirect.com University of Pittsburgh Medical Center

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2252658Upmc Western Behaviroal HLTH at Safe Harbor Crisis2556 West 12TH Street, Erie, PA 16505Certificate of waiverFeb 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Safe Harbor Behavioral Health of Upmc Hamot6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1659133668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-451-2232",
            "fax_number": "814-454-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2556 W 12TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054508",
            "telephone_number": "814-835-2960",
            "fax_number": "814-833-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR BEHAVIORAL HEALTH OF UPMC HAMOT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPMC",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "FAUBLE",
        "authorized_official_first_name": "MANDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR CLINICAL CARE SERVICES",
        "authorized_official_telephone_number": "814-451-2225"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "455580",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "safeharbor@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "University of Pittsburgh Medical Center",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UPMC Western Behavioral Health at Safe Harbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.