Provider Demographics
NPI:1013233204
Name:SAFE HARBOR FAMILY SERVICES
Entity Type:Organization
Organization Name:SAFE HARBOR FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:PEDIGO
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:931-648-4897
Mailing Address - Street 1:120 CENTER POINTE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-1632
Mailing Address - Country:US
Mailing Address - Phone:931-648-4897
Mailing Address - Fax:931-906-9735
Practice Address - Street 1:120 CENTER POINTE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-1632
Practice Address - Country:US
Practice Address - Phone:931-648-4897
Practice Address - Fax:931-906-9735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN674106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty