Provider Demographics
NPI:1225662885
Name:SAFE HARBOR CATHOLIC COUNSELING INSTITUTE
Entity Type:Organization
Organization Name:SAFE HARBOR CATHOLIC COUNSELING INSTITUTE
Other - Org Name:SAFE HARBOR CCI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-342-6681
Mailing Address - Street 1:13149 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4007
Mailing Address - Country:US
Mailing Address - Phone:909-342-6681
Mailing Address - Fax:909-413-0241
Practice Address - Street 1:13149 3RD ST
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4007
Practice Address - Country:US
Practice Address - Phone:909-342-6681
Practice Address - Fax:909-413-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-23
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100208OtherLICENSE LIFE MARRIED FAMILY THERAPIST
CA116288OtherLICENSE LIFE MARRIED FAMILY THERAPIST
CA86375OtherLICENSE LIFE MARRIED FAMILY THERAPIST
CAAMFT105366OtherLICENSE LIFE MARRIAGE FAMILY THERAPIST