# HARBORSIDE BEHAVIORAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972069201
- **Authorized official:** SABRINA SEPULVEDA CRNP-PMH (OWNER)
- **Authorized official phone:** (301) 494-1009

## Contact information

- **Practice address:** 41625 PARK AVE, LEONARDTOWN, MD 20650-3894
- **Practice address phone:** (301) 494-1009
- **Practice address fax:** (970) 296-5636
- **Mailing address:** PO BOX 452, VALLEY LEE, MD 20692-0452
- **Mailing address phone:** (443) 401-1376
- **Mailing address fax:** (970) 296-5636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2019
- **Last updated:** 10/14/2022