| Tides Of Change Counseling | |
|
67 Apple St Tinton Falls NJ 07724-2636 | |
| (603) 361-6402 | |
| Not Available |
| Full Name | Tides Of Change Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 67 Apple St, Tinton Falls, New Jersey |
| Authorized Official Name and Position | Kristine Lane (OWNER) |
| Authorized Official Contact | 6033616402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tides Of Change Counseling Po Box 8502 Red Bank NJ 07701-8502 Ph: () - | Tides Of Change Counseling 67 Apple St Tinton Falls NJ 07724-2636 Ph: (603) 361-6402 |
| NPI Number | 1508578717 |
|---|---|
| Provider Enumeration Date | 12/19/2022 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/19/2022 |
| Medicare PECOS PAC ID | 0446623920 |
|---|---|
| Medicare Enrollment ID | O20230303000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508578717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristine Lane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518698554 PECOS PAC ID: 5991180465 Enrollment ID: I20220920000677 |
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