CHANGING TIDES COUNSELING, LLC – NPI #1639887672
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Health Care Provider Taxonomy Code for Clinic/Center

CHANGING TIDES COUNSELING, LLC is an AHC clinic located in CLEARWATER, FL. NPPES has assigned the NPI number 1639887672 to CHANGING TIDES COUNSELING, LLC on November 08, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0855X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adolescent and Children Mental Health

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHANGING TIDES COUNSELING, LLC below.

NPI Profile for
CHANGING TIDES COUNSELING, LLC

NPI Number
1639887672
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHANGING TIDES COUNSELING, LLC
Primary location
51 S MAIN AVE STE 304
CLEARWATER, FL 33765-3937
Phone: (920) 370-7680 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SAMANTHA PETROSHIUS-CROCKER
OWNER/MANAGER
Phone: (813) 461-5370
Updated
Certification Date
Nov 08, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for CHANGING TIDES COUNSELING, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidFL21772400
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0855X
- Clinic/Center / Adolescent and Children Mental Health (Primary)
261QM0850X
- Clinic/Center / Adult Mental Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.