Provider Demographics
NPI:1679201982
Name:SAFE HARBOR COUNSELING
Entity Type:Organization
Organization Name:SAFE HARBOR COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:801-510-7230
Mailing Address - Street 1:1438 N 615 E
Mailing Address - Street 2:
Mailing Address - City:SHELLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83274-5077
Mailing Address - Country:US
Mailing Address - Phone:801-510-7230
Mailing Address - Fax:
Practice Address - Street 1:1075 S UTAH AVE STE 356
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-3334
Practice Address - Country:US
Practice Address - Phone:208-274-4720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-13
Last Update Date:2022-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty