| Tides Of Mind Counseling | |
|
230 Frost Rd Unit B Waterbury CT 06705-2154 | |
| (203) 819-0789 | |
| Not Available |
| Full Name | Tides Of Mind Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 230 Frost Rd Unit B, Waterbury, Connecticut |
| Authorized Official Name and Position | Elliot Richelson (PRESIDENT, SECRETARY, AND TREASURER) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tides Of Mind Counseling 230 Frost Rd Unit B Waterbury CT 06705-2154 Ph: (203) 768-4427 | Tides Of Mind Counseling 230 Frost Rd Unit B Waterbury CT 06705-2154 Ph: (203) 819-0789 |
| NPI Number | 1295130581 |
|---|---|
| Provider Enumeration Date | 10/29/2014 |
| Last Update Date | 04/04/2023 |
| Certification Date | 04/04/2023 |
| Medicare PECOS PAC ID | 1557614856 |
|---|---|
| Medicare Enrollment ID | O20181105000405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295130581 | NPI | - | NPPES |
| 008056440 | Medicaid | CT |
| Provider Name | Ryan Marc Lieberman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548483654 PECOS PAC ID: 9830107762 Enrollment ID: I20060404000080 |
| Provider Name | Lynn Mccaffrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326064338 PECOS PAC ID: 4385720408 Enrollment ID: I20080328000480 |
| Provider Name | Mahmoud S Okasha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083890016 PECOS PAC ID: 5991875890 Enrollment ID: I20080604000371 |
| Provider Name | Donna M Tanganelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962614677 PECOS PAC ID: 8527105030 Enrollment ID: I20091102000087 |
| Provider Name | Megan Klein |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1437232766 PECOS PAC ID: 5698963171 Enrollment ID: I20101228000527 |
| Provider Name | Joyce S Armstrong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881832327 PECOS PAC ID: 8022292705 Enrollment ID: I20110404000601 |
| Provider Name | Tamar T Saunders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619271624 PECOS PAC ID: 1153505300 Enrollment ID: I20110412000828 |
| Provider Name | Laura Palmese |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184906448 PECOS PAC ID: 9335392950 Enrollment ID: I20130110000366 |
| Provider Name | Sandra R Summer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629370739 PECOS PAC ID: 2466699251 Enrollment ID: I20130515000463 |
| Provider Name | Jessica M Screen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609116029 PECOS PAC ID: 2062650856 Enrollment ID: I20130606000567 |
| Provider Name | Sharif J Okasha |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518027325 PECOS PAC ID: 1254477342 Enrollment ID: I20150130000405 |
| Provider Name | Renee L Lacadie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265818355 PECOS PAC ID: 7618285008 Enrollment ID: I20151005002316 |
| Provider Name | Carrie A. Miranda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588096440 PECOS PAC ID: 1557664695 Enrollment ID: I20160122000995 |
| Provider Name | Kathleen Hustek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184027203 PECOS PAC ID: 9436454436 Enrollment ID: I20160301000555 |
| Provider Name | Mark Nadolski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851607030 PECOS PAC ID: 7113205832 Enrollment ID: I20161101001679 |
| Provider Name | Heather M Humphrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346785086 PECOS PAC ID: 3678856796 Enrollment ID: I20170215000102 |
| Provider Name | Laurie G Mazzarella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396960274 PECOS PAC ID: 2668719576 Enrollment ID: I20190131001065 |
| Provider Name | Barbara Krill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316494990 PECOS PAC ID: 7315287372 Enrollment ID: I20190329000356 |
| Provider Name | Victoria Schuch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720529670 PECOS PAC ID: 0648503326 Enrollment ID: I20190612000856 |
| Provider Name | Jaclyn Elizabeth Alessio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902458359 PECOS PAC ID: 1850622762 Enrollment ID: I20191008000779 |
| Provider Name | Michele J Chenevert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215016332 PECOS PAC ID: 7911332515 Enrollment ID: I20200108001346 |
| Provider Name | Margaret Lillian Lionsbeard Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306381660 PECOS PAC ID: 9638506710 Enrollment ID: I20200302002036 |
| Provider Name | Alexis Marie Larowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801324678 PECOS PAC ID: 2264861152 Enrollment ID: I20200327001075 |
| Provider Name | Marian Hogan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104200781 PECOS PAC ID: 8628384831 Enrollment ID: I20200428000221 |
| Provider Name | Hairong Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154952794 PECOS PAC ID: 7810318664 Enrollment ID: I20200602002468 |
| Provider Name | Michelle Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215563168 PECOS PAC ID: 8628494077 Enrollment ID: I20200811003847 |
| Provider Name | Carolyn Sowa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477630697 PECOS PAC ID: 6507270758 Enrollment ID: I20210128002491 |
| Provider Name | Marie Goodine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023642998 PECOS PAC ID: 1355755240 Enrollment ID: I20210204002679 |
| Provider Name | Shelly Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518418300 PECOS PAC ID: 3072927979 Enrollment ID: I20210204002759 |
| Provider Name | Desiree Nicole Emirzian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669948428 PECOS PAC ID: 5395151807 Enrollment ID: I20210309000125 |
| Provider Name | Rachael Elizabeth Burke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588937114 PECOS PAC ID: 5799191144 Enrollment ID: I20210309002139 |
| Provider Name | Madison Mcnally Dahm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700407905 PECOS PAC ID: 3779991245 Enrollment ID: I20210421002951 |
| Provider Name | Rio Elena Comaduran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477065043 PECOS PAC ID: 2769881309 Enrollment ID: I20210601002432 |
| Provider Name | Dana Segall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982149480 PECOS PAC ID: 1355742156 Enrollment ID: I20210630003836 |
| Provider Name | Nicole Damato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497364756 PECOS PAC ID: 4880090612 Enrollment ID: I20210902001917 |
| Provider Name | Carly Gambardella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447726120 PECOS PAC ID: 6901202688 Enrollment ID: I20210903000709 |
| Provider Name | Cathleen Nowak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346712031 PECOS PAC ID: 8325446263 Enrollment ID: I20211007001769 |
| Provider Name | Lauren Scharn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144730367 PECOS PAC ID: 4789072661 Enrollment ID: I20211026001655 |
| Provider Name | Rebecca Rotondo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003358326 PECOS PAC ID: 3971996349 Enrollment ID: I20220207001903 |
| Provider Name | Alexis Loren Greenwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700506680 PECOS PAC ID: 0941685150 Enrollment ID: I20220923000403 |
| Provider Name | Kristal Alexis Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295380913 PECOS PAC ID: 3274904560 Enrollment ID: I20230124003231 |
| Provider Name | Kelly Tarascio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174112262 PECOS PAC ID: 9234500554 Enrollment ID: I20230125000858 |
| Provider Name | Carly Rae Jacques |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467022830 PECOS PAC ID: 9739551086 Enrollment ID: I20230214001757 |
| Provider Name | Paulette Atse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861112013 PECOS PAC ID: 7719350917 Enrollment ID: I20230309002000 |
| Provider Name | Christina Kalogeris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811542715 PECOS PAC ID: 7517332703 Enrollment ID: I20230330002028 |
| Provider Name | Karissa Piedescalzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932556602 PECOS PAC ID: 8628442894 Enrollment ID: I20230407000440 |
| Provider Name | Anastasia Zahara Campos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033783881 PECOS PAC ID: 2567837073 Enrollment ID: I20230417000194 |
| Provider Name | Brittany Muldowney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114647922 PECOS PAC ID: 8325403744 Enrollment ID: I20230508000984 |
| Provider Name | Michele Granville Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902388234 PECOS PAC ID: 4183083983 Enrollment ID: I20230711001546 |
| Provider Name | Joseph John Jacovino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710422068 PECOS PAC ID: 8426417262 Enrollment ID: I20230711002762 |
| Provider Name | Taurus Lazine Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063868982 PECOS PAC ID: 8729449194 Enrollment ID: I20230801003391 |
| Provider Name | Alyssa Ashly Kondor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164991451 PECOS PAC ID: 1557723640 Enrollment ID: I20230822002407 |
| Provider Name | Sarah Elizabeth O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245823426 PECOS PAC ID: 0244693331 Enrollment ID: I20230822002648 |
| Provider Name | Idalia Centeno-diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225536519 PECOS PAC ID: 3870978794 Enrollment ID: I20230831004247 |
| Provider Name | Kerin B Foley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154337004 PECOS PAC ID: 4981068095 Enrollment ID: I20230907003281 |
| Provider Name | Timothy John Rowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073173035 PECOS PAC ID: 1153775648 Enrollment ID: I20231003000781 |
| Provider Name | Chelsea N Humphrey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548555816 PECOS PAC ID: 3678940582 Enrollment ID: I20240118003297 |
| Provider Name | Jodi-kae C Joseph |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851999577 PECOS PAC ID: 3173966033 Enrollment ID: I20240207002255 |
| Provider Name | Blake Gilbert Reuter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114318789 PECOS PAC ID: 9537502372 Enrollment ID: I20240208000828 |
| Provider Name | Ricacha Tashana Jimenez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407152168 PECOS PAC ID: 2365885126 Enrollment ID: I20240208001563 |
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