NPIMap

Organization Active NPI

Safe Harbor Christian of Annapolis

  • Professional Counselor
  • Annapolis, MD
National Provider Identifier
1710356142
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SAFE HARBOR CHRISTIAN OF ANNAPOLIS
Practice address
1071 Bay Ridge Rd
Annapolis, MD 21403-4225
Phone
(410) 893-4600
Fax
(443) 640-4358
NPI assigned
Sep 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Authorized official

Name
Selena Eldridge
Title
Director
Phone
(410) 893-4600

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

1071 Bay Ridge Rd
Annapolis, MD 21403-4225

Mailing address

946 Nabbs Creek Rd
Glen Burnie, MD 21060-8434
Phone (410) 893-4600

Other identifiers 1

IdentifierTypeStateIssuer
383298OtherMDPTAN

National Provider Directory

National Provider Directory
Tax ID family
Safe Harbor Christian Counseling of Annapolis13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

1071 Bay Ridge Rd
Annapolis, MD 21403

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1710356142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 NABBS CREEK RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608434",
            "telephone_number": "410-893-4600",
            "fax_number": "443-640-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 BAY RIDGE RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214034225",
            "telephone_number": "410-893-4600",
            "fax_number": "443-640-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR CHRISTIAN OF ANNAPOLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "SELENA",
        "authorized_official_title_or_position": "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": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "383298",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.