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TIDELAND MENTAL HEALTH CENTER NPI 1801806500


NPI Information

NPI: 1801806500
Provider Name: TIDELAND MENTAL HEALTH CENTER
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
1308 HIGHLAND DR
WASHINGTON, NC
ZIP 27889
Phone: (252) 946-8061
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TIDELAND MENTAL HEALTH CENTER is a counselor in Washington, 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 NPI is 1801806500. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1308 HIGHLAND DR
WASHINGTON, NC
ZIP 27889-424
Phone: (252) 946-8061
Fax: (252) 946-8078

The provider's authorized official is Barbara R 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 8/8/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorYes
2101YP2500XCounselorProfessionalX
31041C0700XSocial WorkerClinicalX
4106H00000XMarriage & Family TherapistX

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
16005470MEDICAIDNORTH CAROLINA

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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