| Tides Of Change Therapy Services Pllc | |
|
300 W Hargett St Unit 234 Raleigh NC 27601-1596 | |
| (984) 788-6570 | |
| (844) 861-1194 |
| Full Name | Tides Of Change Therapy Services Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 300 W Hargett St Unit 234, Raleigh, North Carolina |
| Authorized Official Name and Position | Carleigh Davis Weaver (MEMBER OWNER) |
| Authorized Official Contact | 8048225073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tides Of Change Therapy Services Pllc 300 W Hargett St Unit 234 Raleigh NC 27601-1596 Ph: (984) 788-6570 | Tides Of Change Therapy Services Pllc 300 W Hargett St Unit 234 Raleigh NC 27601-1596 Ph: (984) 788-6570 |
| NPI Number | 1417520891 |
|---|---|
| Provider Enumeration Date | 07/22/2021 |
| Last Update Date | 07/22/2021 |
| Certification Date | 07/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417520891 | NPI | - | NPPES |
| 1336293000 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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