| Rising Tide Counseling Pllc | |
|
1385 Eisenhower Cir Apt 401 Woodbridge VA 22191-5229 | |
| (703) 899-2434 | |
| Not Available |
| Full Name | Rising Tide Counseling Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1385 Eisenhower Cir Apt 401, Woodbridge, Virginia |
| Authorized Official Name and Position | Caise Shea Castle (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7038992434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Tide Counseling Pllc 1385 Eisenhower Cir Apt 401 Woodbridge VA 22191-5229 Ph: (703) 899-2434 | Rising Tide Counseling Pllc 1385 Eisenhower Cir Apt 401 Woodbridge VA 22191-5229 Ph: (703) 899-2434 |
| NPI Number | 1821806738 |
|---|---|
| Provider Enumeration Date | 12/23/2024 |
| Last Update Date | 12/23/2024 |
| Certification Date | 12/23/2024 |
| Medicare PECOS PAC ID | 3779008222 |
|---|---|
| Medicare Enrollment ID | O20250417001391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821806738 | NPI | - | NPPES |
| 1699056259 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Caise Shea Castle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699056259 PECOS PAC ID: 4688199136 Enrollment ID: I20250417001700 |
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