| Changing Tides Counseling Service, Llc | |
|
209 W Jessamine Ave Foley AL 36535-2010 | |
| (205) 602-7365 | |
| Not Available |
| Full Name | Changing Tides Counseling Service, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 209 W Jessamine Ave, Foley, Alabama |
| Authorized Official Name and Position | Jessica Sanders (SOLE OWNER) |
| Authorized Official Contact | 2056027365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Tides Counseling Service, Llc 294 Cypress Lake Dr Gulf Shores AL 36542-9102 Ph: () - | Changing Tides Counseling Service, Llc 209 W Jessamine Ave Foley AL 36535-2010 Ph: (205) 602-7365 |
| NPI Number | 1205469061 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 05/12/2023 |
| Certification Date | 05/12/2023 |
| Medicare PECOS PAC ID | 0840640447 |
|---|---|
| Medicare Enrollment ID | O20231222000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205469061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica Lorraine Sanders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669734174 PECOS PAC ID: 0143473918 Enrollment ID: I20130102000293 |
| Provider Name | Joshua Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043901895 PECOS PAC ID: 8426419649 Enrollment ID: I20230803001170 |
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