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CLINICAL ASSOCIATES OF TIDEWATER P.C. NPI 1124060314


NPI Information

NPI: 1124060314
Provider Name: CLINICAL ASSOCIATES OF TIDEWATER, P.C.
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
6320 N CENTER DR
SUITE 101
NORFOLK, VA
ZIP 23502
Phone: (757) 456-0505
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CLINICAL ASSOCIATES OF TIDEWATER, P.C. is a clinical psychologist in Norfolk, VA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. CLINICAL ASSOCIATES OF TIDEWATER, P.C. NPI is 1124060314. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6320 N CENTER DR
SUITE 101
NORFOLK, VA
ZIP 23502-009
Phone: (757) 456-0505
Fax: (757) 456-0817

The provider's authorized official is Rebecca Dean Reid .
The authorized official title is President and has the following contact phone number (757) 456-0505.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 8/2/2010.


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 WorkerClinicalNo
2103TC0700XPsychologistClinicalYes

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
193140OTHERVIRGINIACAROLYN JOHNSON-ANTHEM
2R60571MEDICARE UPINVIRGINIA
3800000241MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAREBECCA D. REID, LCSW
4370000881MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAFRANK AIELLO, MD.
58917124MEDICAIDVIRGINIA
6F57284MEDICARE UPINVIRGINIA
7216460OTHERVIRGINIAMARK YARHOUSE-ANTHEM
8322713OTHERVIRGINIAFRANK AIELLO,MD - ANTHEM
9R65897MEDICARE UPINVIRGINIA
106717951MEDICAIDVIRGINIA
117730667MEDICAIDVIRGINIA
1272702OTHERVIRGINIAREBECCA REID - ANTHEM
13R60662MEDICARE UPINVIRGINIA
14680000273MEDICARE ID-TYPE UNSPECIFIEDVIRGINIANANCY PASCHALL, PH.D
157704241MEDICAIDVIRGINIA
1672705OTHERVIRGINIANANCY PASCHALL-ANTHEM
17CO2801MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAGROUP NUMBER
187761775MEDICAIDVIRGINIA
197702451MEDICAIDVIRGINIA

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: 4/28/2024

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