TIDELAND MENTAL HEALTH CENTER- MATT OPP NPI 1053441782

NPI Information

  • NPI: 1053441782
  • Provider Name: TIDELAND MENTAL HEALTH CENTER- MATT OPP
  • Classification: Counselor - 101Y00000X
  • Entity Type: Organization
  • Address: 69 CHURCH STREET
    FAIRFIELD, NC
    ZIP 27826
  • Phone: (252) 926-3731

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NPI Details

TIDELAND MENTAL HEALTH CENTER- MATT OPP is a counselor in Fairfield, NC. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. TIDELAND MENTAL HEALTH CENTER- MATT OPP NPI is 1053441782. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

69 CHURCH STREET
FAIRFIELD, NC
ZIP 27826
Phone: (252) 926-3731
Fax: (252) 926-3213

The provider's authorized official is Barbara Moore .
The authorized official title is Area Director and has the following contact phone number (252) 946-8061.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 8/22/2020.

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
1101Y00000XCounselorYes
2101YP2500XCounselorProfessionalX
31041C0700XSocial WorkerClinicalX
4106H00000XMarriage & Family TherapistX

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: 3/30/2025

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