Provider Demographics
NPI:1225436843
Name:SAFE HAVEN RELATIONSHIP COUNSELING CENTER
Entity Type:Organization
Organization Name:SAFE HAVEN RELATIONSHIP COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-614-4555
Mailing Address - Street 1:2544 MUIRFIELDS DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-3092
Mailing Address - Country:US
Mailing Address - Phone:626-614-4555
Mailing Address - Fax:
Practice Address - Street 1:2782 GATEWAY RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-1730
Practice Address - Country:US
Practice Address - Phone:626-614-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39408106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty