Provider Demographics
NPI:1477889137
Name:SAFE HARBOR CHRISTIAN COUNSELING OF SOUTH CENTRAL PA, LLC
Entity Type:Organization
Organization Name:SAFE HARBOR CHRISTIAN COUNSELING OF SOUTH CENTRAL PA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:717-377-6930
Mailing Address - Street 1:239 WHITLEY DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-8790
Mailing Address - Country:US
Mailing Address - Phone:717-377-6930
Mailing Address - Fax:
Practice Address - Street 1:239 WHITLEY DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-8790
Practice Address - Country:US
Practice Address - Phone:717-377-6930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005312251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health