Organization
SAFE HARBOR CHRISTIAN COUNSELING OF ANNAPOLIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SELENA ELDRIDGE (DIRECTOR)
(410) 893-4600
Entity
Organization
Contact information
Practice address
8146 QUARTERFIELD RD, SEVERN, MD 21144-2705
(410) 893-4600
(443) 640-4358
Mailing address
946 NABBS CREEK RD, GLEN BURNIE, MD 21060-8434
(410) 893-4600
(443) 640-4358
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383298
MEDICARE PTAN
MD
Enumeration date
09/17/2015
Last updated
09/17/2015
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