| Safe Harbor Behavioral Care Chesapeake Llc | |
| 
					108 Old Solomons Island Rd Unit 5 Annapolis MD 21401-3845  | |
| (410) 807-2626 | |
| Not Available | 
| Full Name | Safe Harbor Behavioral Care Chesapeake Llc | 
|---|---|
| Speciality | Social Worker | 
| Location | 108 Old Solomons Island Rd Unit 5, Annapolis, Maryland | 
| Authorized Official Name and Position | Selena Eldride (REGIONAL DIRECTOR) | 
| Authorized Official Contact | 4108072626 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Safe Harbor Behavioral Care Chesapeake Llc 946 Nabbs Creek Rd Glen Burnie MD 21060-8434 Ph: (410) 807-2626  | Safe Harbor Behavioral Care Chesapeake Llc 108 Old Solomons Island Rd Unit 5 Annapolis MD 21401-3845 Ph: (410) 807-2626  | 
| NPI Number | 1295246718 | 
|---|---|
| Provider Enumeration Date | 10/24/2017 | 
| Last Update Date | 06/16/2018 | 
| Medicare PECOS PAC ID | 0042578171 | 
|---|---|
| Medicare Enrollment ID | O20171219003042 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1295246718 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary | 
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary | 
| Provider Name | Carolyn F Mcdonald | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1285641639 PECOS PAC ID: 7517911357 Enrollment ID: I20050304000385  | 
| Provider Name | Michele G Stanton | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1902908270 PECOS PAC ID: 7911060660 Enrollment ID: I20090107000354  | 
| 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 | Sabrina P Lueth Walker | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1700295433 PECOS PAC ID: 6103102512 Enrollment ID: I20170420000759  | 
| Provider Name | Shannon L Miller | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1922599984 PECOS PAC ID: 9931454659 Enrollment ID: I20180621001195  | 
| Provider Name | Erin Teigen | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1669068086 PECOS PAC ID: 0941604326 Enrollment ID: I20210806001498  | 
| Provider Name | Denise Mckoy | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1033776364 PECOS PAC ID: 8628476017 Enrollment ID: I20211015001692  | 
| Provider Name | Dragana Hrvat | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1518461367 PECOS PAC ID: 7911348842 Enrollment ID: I20240509002467  | 
| Provider Name | Elaine Marie Wallace | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1962084574 PECOS PAC ID: 0345773404 Enrollment ID: I20241028001998  | 
| Provider Name | Jane Spell | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1689921371 PECOS PAC ID: 4486189826 Enrollment ID: I20241122000711  | 
| Provider Name | Kathryn Marcus | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1760122931 PECOS PAC ID: 0446786404 Enrollment ID: I20241213001515  | 
| Provider Name | Kelly Stauffer | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1558938845 PECOS PAC ID: 3072041136 Enrollment ID: I20250116003530  | 
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Project Chesapeake Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Old Solomons Island Rd, Building 2 Suite 1, Annapolis, MD 21401 Phone: 443-214-5097 Fax: 443-378-8538  |