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SAFE HARBOR CLINIC LLC NPI 1609352384


NPI Information

NPI: 1609352384
Provider Name: SAFE HARBOR CLINIC LLC
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
4013 BEATLINE RD STE A
LONG BEACH, MS
ZIP 39560
Phone: (228) 200-0720
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SAFE HARBOR CLINIC LLC is a psychiatry psychiatry neurology in Long Beach, MS. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. SAFE HARBOR CLINIC LLC NPI is 1609352384. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4013 BEATLINE RD STE A
LONG BEACH, MS
ZIP 39560
Phone: (228) 200-0720
Fax: (228) 200-0383

The provider's authorized official is Dustin Marmalich .
The authorized official title is Owner and has the following contact phone number (228) 200-0720.

The enumeration date for this NPI number is 7/16/2018 and was last updated on 8/30/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalC9311MISSISSIPPINo
22084P0800XPsychiatry & NeurologyPsychiatry25543MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104334707MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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