Provider Demographics
NPI:1841005543
Name:HARBOR SITE COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:HARBOR SITE COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH, QMHP
Authorized Official - Phone:605-692-4970
Mailing Address - Street 1:1733 TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-5418
Mailing Address - Country:US
Mailing Address - Phone:307-689-5730
Mailing Address - Fax:605-692-4972
Practice Address - Street 1:611 MAIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-1424
Practice Address - Country:US
Practice Address - Phone:307-689-5730
Practice Address - Fax:605-692-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty