| Safe Harbor Behavioral Care, Llc | |
|
2227 Old Emmorton Rd Ste 119 Bel Air MD 21015 | |
| (410) 893-4600 | |
| (443) 640-4358 |
| Full Name | Safe Harbor Behavioral Care, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2227 Old Emmorton Rd, Bel Air, Maryland |
| Authorized Official Name and Position | Erik Sundquist (NATIONAL DIRECTOR) |
| Authorized Official Contact | 4108934600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Safe Harbor Behavioral Care, Llc 1208 E Churchville Rd Ste 300 Bel Air MD 21014-3442 Ph: (410) 893-4600 | Safe Harbor Behavioral Care, Llc 2227 Old Emmorton Rd Ste 119 Bel Air MD 21015 Ph: (410) 893-4600 |
| NPI Number | 1316487879 |
|---|---|
| Provider Enumeration Date | 03/03/2017 |
| Last Update Date | 06/21/2018 |
| Medicare PECOS PAC ID | 0345514675 |
|---|---|
| Medicare Enrollment ID | O20170925002242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316487879 | NPI | - | NPPES |
| Provider Name | Carol Ivy Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659340057 PECOS PAC ID: 5799766424 Enrollment ID: I20040527000751 |
| Provider Name | Robert Ciaverelli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689681983 PECOS PAC ID: 3577514983 Enrollment ID: I20050202001005 |
| Provider Name | Jerry Lawler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710076278 PECOS PAC ID: 9739134354 Enrollment ID: I20050316000999 |
| Provider Name | William R Walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093861502 PECOS PAC ID: 9436171121 Enrollment ID: I20051221000996 |
| Provider Name | Wendy E Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548283666 PECOS PAC ID: 5698868370 Enrollment ID: I20070911000820 |
| Provider Name | Erik Sundquist |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518009471 PECOS PAC ID: 9739279811 Enrollment ID: I20071212000720 |
| Provider Name | Sally Fogle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316185671 PECOS PAC ID: 4587721386 Enrollment ID: I20090323000375 |
| Provider Name | Patricia M Itzel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417263674 PECOS PAC ID: 9032395611 Enrollment ID: I20110516000714 |
| Provider Name | Karen L Bradley Poff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205152857 PECOS PAC ID: 7113104373 Enrollment ID: I20110615000771 |
| Provider Name | Sandra J. Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982925863 PECOS PAC ID: 4385813526 Enrollment ID: I20110804000611 |
| Provider Name | Joan M Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588845234 PECOS PAC ID: 8426221060 Enrollment ID: I20111027000305 |
| Provider Name | Michelle J Pearce |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871740159 PECOS PAC ID: 2062578461 Enrollment ID: I20121024000310 |
| Provider Name | Camellia B Burton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811260615 PECOS PAC ID: 0547403891 Enrollment ID: I20130905000490 |
| Provider Name | Kiu Eubanks Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043536709 PECOS PAC ID: 4183859275 Enrollment ID: I20131025000978 |
| Provider Name | Robert Basler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972751931 PECOS PAC ID: 5092931113 Enrollment ID: I20140728000096 |
| Provider Name | Julia Mcgovern |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548319320 PECOS PAC ID: 3476770801 Enrollment ID: I20140808000879 |
| Provider Name | Laura Ochs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093059982 PECOS PAC ID: 5193942472 Enrollment ID: I20140811000161 |
| Provider Name | Renita Somerville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043562366 PECOS PAC ID: 2163640988 Enrollment ID: I20140820000543 |
| Provider Name | Stephen Osterhout |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528246485 PECOS PAC ID: 5890913628 Enrollment ID: I20140820000970 |
| Provider Name | Jeffrey O Donnell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144432931 PECOS PAC ID: 6709005432 Enrollment ID: I20140911001675 |
| Provider Name | Stefanie Plitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659782266 PECOS PAC ID: 6901025568 Enrollment ID: I20140912000865 |
| Provider Name | Nikole Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144324567 PECOS PAC ID: 4880813278 Enrollment ID: I20140917001390 |
| Provider Name | Kathleen E Kilgalen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750716189 PECOS PAC ID: 7315166634 Enrollment ID: I20140919000172 |
| Provider Name | Judie Thompson Stokes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568659555 PECOS PAC ID: 9830310382 Enrollment ID: I20141027000143 |
| Provider Name | Sharon Hardy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679714133 PECOS PAC ID: 8729306295 Enrollment ID: I20150413001411 |
| Provider Name | Shelby J John |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881882165 PECOS PAC ID: 3274841093 Enrollment ID: I20150929000178 |
| Provider Name | Marina Gethers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992177851 PECOS PAC ID: 8921308362 Enrollment ID: I20151208000030 |
| Provider Name | Jennifer Maxfield Decarlo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376590414 PECOS PAC ID: 3678865292 Enrollment ID: I20160630000175 |
| Provider Name | Evelyn Wenzel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962598607 PECOS PAC ID: 3476770868 Enrollment ID: I20161006000555 |
| Provider Name | Wanda Ranee Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194892562 PECOS PAC ID: 2769435858 Enrollment ID: I20170124001810 |
| Provider Name | Donna L Benford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689042533 PECOS PAC ID: 6608151576 Enrollment ID: I20170316001707 |
| Provider Name | Linda Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528191871 PECOS PAC ID: 3072885334 Enrollment ID: I20170821002989 |
| Provider Name | Danielle Spitelle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528305844 PECOS PAC ID: 1850650110 Enrollment ID: I20180111001474 |
| Provider Name | Yekeen K Odewale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184175697 PECOS PAC ID: 1759640592 Enrollment ID: I20180124000717 |
| Provider Name | Victoria Mojibola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841789146 PECOS PAC ID: 3678838919 Enrollment ID: I20180607001380 |
| Provider Name | Samantha Cohose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326515974 PECOS PAC ID: 3971847922 Enrollment ID: I20181203002473 |
| Provider Name | Nji J Fru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275893794 PECOS PAC ID: 8224374319 Enrollment ID: I20190110001390 |
| Provider Name | Judith Railson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124580469 PECOS PAC ID: 0143553784 Enrollment ID: I20190613000252 |
| Provider Name | Gaelle Nyasa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144781196 PECOS PAC ID: 7113251596 Enrollment ID: I20190619002417 |
| Provider Name | Myra Waters |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003296617 PECOS PAC ID: 9931434362 Enrollment ID: I20190708002210 |
| Provider Name | Eric Angeme Amene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750641221 PECOS PAC ID: 9830424209 Enrollment ID: I20190709000609 |
| Provider Name | Leo Fenzel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124106000 PECOS PAC ID: 7315277951 Enrollment ID: I20190925001761 |
| Provider Name | Sharelle A Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790070795 PECOS PAC ID: 5597085654 Enrollment ID: I20200116000063 |
| Provider Name | Telisa Michelle Hickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700369956 PECOS PAC ID: 4385971654 Enrollment ID: I20200207000341 |
| Provider Name | Kaitlan Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003380643 PECOS PAC ID: 6800209339 Enrollment ID: I20201230001491 |
| Provider Name | Georgina M Irondi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093986879 PECOS PAC ID: 2567877400 Enrollment ID: I20210226000916 |
| Provider Name | Kamiylah Abdul Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003403031 PECOS PAC ID: 4880003094 Enrollment ID: I20210429000223 |
| Provider Name | Daniel Heckman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306486220 PECOS PAC ID: 2567861263 Enrollment ID: I20210601000438 |
| Provider Name | Jami K Hicks-townes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477133395 PECOS PAC ID: 7214339449 Enrollment ID: I20210712001056 |
| Provider Name | Vera Ngezem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598316796 PECOS PAC ID: 2264868538 Enrollment ID: I20210914002564 |
| Provider Name | Margaret Kazmierski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629302781 PECOS PAC ID: 7517344773 Enrollment ID: I20220510001161 |
| Provider Name | Lisa Stanford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255924114 PECOS PAC ID: 3577940501 Enrollment ID: I20220513000335 |
| Provider Name | Celena A Bryant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043652464 PECOS PAC ID: 8729212600 Enrollment ID: I20220624001048 |
| Provider Name | Kathleen Dodson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619411428 PECOS PAC ID: 4880077387 Enrollment ID: I20220816003022 |
| Provider Name | Frida Fru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447511167 PECOS PAC ID: 9830587880 Enrollment ID: I20221020001748 |
| Provider Name | Jonathan Decarlo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548731995 PECOS PAC ID: 7012389497 Enrollment ID: I20230213000421 |
| Provider Name | Erica Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861966582 PECOS PAC ID: 9931572583 Enrollment ID: I20230301000585 |
| Provider Name | Jessica Savage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669148763 PECOS PAC ID: 9032584578 Enrollment ID: I20230413003151 |
| Provider Name | Shirley Wolf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700340015 PECOS PAC ID: 0345605978 Enrollment ID: I20230503001491 |
| Provider Name | Gelisa Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487027421 PECOS PAC ID: 8729432406 Enrollment ID: I20230928003262 |
| Provider Name | Jazmyn Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124696042 PECOS PAC ID: 6406202423 Enrollment ID: I20231104000797 |
| Provider Name | Diane Blackmon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053933796 PECOS PAC ID: 7012366057 Enrollment ID: I20231215000649 |
| Provider Name | June Dickerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245857713 PECOS PAC ID: 0941643969 Enrollment ID: I20240207000622 |
| Provider Name | Donna Doyle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669065835 PECOS PAC ID: 6709229305 Enrollment ID: I20240212000915 |
| Provider Name | Glenda Flowers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265551345 PECOS PAC ID: 0648615831 Enrollment ID: I20240227003797 |
| Provider Name | Sarah Dey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518165109 PECOS PAC ID: 1153766928 Enrollment ID: I20240302000458 |
| Provider Name | Donna Lucker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851453930 PECOS PAC ID: 3971948746 Enrollment ID: I20240302000461 |
| Provider Name | Emily Marsan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386112852 PECOS PAC ID: 1759727241 Enrollment ID: I20240306003532 |
| Provider Name | Christopher Donaldson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821568189 PECOS PAC ID: 3173960606 Enrollment ID: I20240320001470 |
| Provider Name | Emmanuel Etuke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114516093 PECOS PAC ID: 5395182711 Enrollment ID: I20240321000846 |
| Provider Name | Rosalyn Ceasar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518421718 PECOS PAC ID: 7719327550 Enrollment ID: I20240426003180 |
| Provider Name | Brittny Sharrow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164162459 PECOS PAC ID: 5395186449 Enrollment ID: I20240507003981 |
| Provider Name | Tara Carleton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245648864 PECOS PAC ID: 3072954064 Enrollment ID: I20240508001024 |
| Provider Name | Sandra Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679250484 PECOS PAC ID: 1951742790 Enrollment ID: I20240510003024 |
| Provider Name | Linda Buckmon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558894428 PECOS PAC ID: 7214378934 Enrollment ID: I20240513002557 |
| Provider Name | Sarah Neville |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497347231 PECOS PAC ID: 4587000187 Enrollment ID: I20240521002161 |
| Provider Name | Sanaa Mylan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568845964 PECOS PAC ID: 7113363714 Enrollment ID: I20240522003172 |
| Provider Name | Jacqueline Benton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588128292 PECOS PAC ID: 0446692487 Enrollment ID: I20240522003504 |
| Provider Name | Frederick M Avolio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275915704 PECOS PAC ID: 3476999004 Enrollment ID: I20240523002515 |
| Provider Name | Angela Bates |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457028110 PECOS PAC ID: 1456795913 Enrollment ID: I20240524000178 |
| Provider Name | Amy Patrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942338439 PECOS PAC ID: 5597101030 Enrollment ID: I20240524000262 |
| Provider Name | Jacqueline Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841822251 PECOS PAC ID: 0840636445 Enrollment ID: I20240524000396 |
| Provider Name | Jennifer Sklar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962032847 PECOS PAC ID: 0042752081 Enrollment ID: I20240606000528 |
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