Provider Demographics
NPI:1548874621
Name:SAFE HARBOUR COUNSELING SERVICES
Entity type:Organization
Organization Name:SAFE HARBOUR COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CANSAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:843-441-2317
Mailing Address - Street 1:PO BOX 844
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29901-0844
Mailing Address - Country:US
Mailing Address - Phone:843-441-2317
Mailing Address - Fax:
Practice Address - Street 1:23 LITTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1634
Practice Address - Country:US
Practice Address - Phone:843-441-2317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health