Provider Demographics
NPI:1396191615
Name:SAFE HARBOR COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:SAFE HARBOR COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LITERSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:920-323-5354
Mailing Address - Street 1:2848 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241-3639
Mailing Address - Country:US
Mailing Address - Phone:920-553-1034
Mailing Address - Fax:920-553-1033
Practice Address - Street 1:2848 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-3639
Practice Address - Country:US
Practice Address - Phone:920-553-1034
Practice Address - Fax:920-553-1033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7204123261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)