Safe Harbor Mental Health

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SAFE HARBOR MENTAL HEALTH

Doing business as

Safe Harbor Mental Health

Practice address

33 Jacks LN
Somerset, KY 42501-6152

Phone

(606) 679-0014

Fax

(606) 679-0024

NPI assigned

Nov 13, 2018

Organization subpart

No

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

Authorized official

Name

Katherine L Tillery, LCSW

Title

Owner

Phone

(859) 868-8186

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Safe Harbor Mental Health Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathy Tillery, LCSW

  • Clinical Social Worker
  • Somerset, KY
  • NPI 1992721773
  Medicare reassignment

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1679042279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 JACKS LN",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425016152",
            "telephone_number": "606-679-0014",
            "fax_number": "606-679-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 JACKS LN",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425016152",
            "telephone_number": "606-679-0014",
            "fax_number": "606-679-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-868-8186",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992721773",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safe Harbor Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Ruth, BCBA
• Corna Rutherford, LPCC-S
• Dale Edward Rutledge Sr., M.D.
• Harold H. Rutledge, MD
• James Raymond Rybarczyk, PT
• Saindon & Saindon Family Dentistry Inc
• Evan James Saindon
• Gina L Saindon, DMD
• James L Saindon, DMD
• Saint Joseph Health System, Inc

• Adult Mental Health Clinic/Center in Somerset, KY
• Providers in Somerset, KY by specialty
• Adult Mental Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.