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TIDAL INTEGRATED HEALTH INC NPI 1346933561


NPI Information

NPI: 1346933561
Provider Name: TIDAL INTEGRATED HEALTH, INC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1025 DIRECTOR CT STE E
GREENVILLE, NC
ZIP 27858
Phone: (252) 493-6525
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TIDAL INTEGRATED HEALTH, INC is a clinic center in Greenville, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). TIDAL INTEGRATED HEALTH, INC NPI is 1346933561. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1025 DIRECTOR CT STE E
GREENVILLE, NC
ZIP 27858-996
Phone: (252) 493-6525

The provider's authorized official is Kayzandra Leigh Exum Bond .
The authorized official title is Licensed Psychologist and has the following contact phone number (252) 493-6788.

The enumeration date for this NPI number is 6/1/2023 and was last updated on 6/14/2023.


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
1101Y00000XCounselorNo
2103K00000XBehavior AnalystNo
3103T00000XPsychologistNo
41041C0700XSocial WorkerClinicalNo
5106H00000XMarriage & Family TherapistNo
6261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
7251S00000XCommunity/Behavioral HealthNo
8261Q00000XClinic/CenterYes

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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