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TIDAL NEUROPSYCHOLOGY PLLC NPI 1871999565


NPI Information

NPI: 1871999565
Provider Name: TIDAL NEUROPSYCHOLOGY PLLC
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
19 S HAMPSTEAD VILLAGE DR
HAMPSTEAD, NC
ZIP 28443
Phone: (910) 803-1434
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TIDAL NEUROPSYCHOLOGY PLLC is a clinical neuropsychologist in Hampstead, NC. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. TIDAL NEUROPSYCHOLOGY PLLC NPI is 1871999565. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

19 S HAMPSTEAD VILLAGE DR
HAMPSTEAD, NC
ZIP 28443-934
Phone: (910) 803-1434
Fax: (855) 672-7002

The provider's authorized official is Griffin Pollock Sutton .
The authorized official title is Owner, Member and has the following contact phone number (910) 803-1434.

The enumeration date for this NPI number is 11/7/2014 and was last updated on 11/7/2014.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical4633NORTH CAROLINANo
2103G00000XClinical Neuropsychologist4633NORTH CAROLINAYes

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: 5/5/2024

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