THE HARBOR ON MAIN
NPI 1336387455
Community/Behavioral Health in Lakeport, CA
About The Harbor On Main NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE HARBOR ON MAIN (NPI 1336387455) is a healthcare organization registered as a community/behavioral health in Lakeport, California and active in the NPI registry since January 2009. The organization maintains a secondary practice location in Lower Lake and lists Victoria Jerusha Kelly, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 7
Other Names 1
Secondary Practice Location 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
The Harbor On Main is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
11Medicare enrollment records show 11 clinicians reassign Medicare billing to The Harbor On Main, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (11)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Redwood Community Services, Inc.'s NPI number?
The NPI number for Redwood Community Services, Inc. is 1336387455. It was assigned to this organization in the NPPES registry on January 27, 2009. The provider is also known as The Harbor On Main.
Where is Redwood Community Services, Inc. located?
Redwood Community Services, Inc. is located at 150 S Main St, Lakeport, CA 95453. The listed phone number is (707) 994-5486.
What is Redwood Community Services, Inc.'s specialty?
The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.
Is Redwood Community Services, Inc. enrolled in Medicare?
Yes. Redwood Community Services, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Redwood Community Services, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 4 Medicare specialties reassign their Medicare billing to Redwood Community Services, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (5), Marriage and Family Therapist (4) and Mental Health Counselor (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Redwood Community Services, Inc. was last updated on February 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# The Harbor On Main · NPI 1336387455
Community/Behavioral Health organization in Lakeport, California. Organization record, active in the CMS NPPES registry since January 27, 2009.
## Identity
- **NPI:** 1336387455 (Entity type: Organization)
- **Enumerated:** January 27, 2009
- **Primary specialty:** Community/Behavioral Health · taxonomy 251S00000X
- **Legal business name:** Redwood Community Services, Inc.
- **Organization subpart:** Yes (part of Redwood Community Services, Inc.)
- **Authorized official:** Victoria Kelly, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 150 S MAIN ST, Lakeport, CA 95453-5017
- **Phone:** (707) 994-5486
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 11 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (5), Marriage and Family Therapist (4), Mental Health Counselor (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 12, 2020
- **Other identifiers:** Other 17CC (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1336387455) · Data from the CMS NPPES public registry.