| Rising Tide Licensed Clinical Social Worker A Professional Corp | |
|
249 Morning Sun Ave Mill Valley CA 94941-3503 | |
| (309) 868-3809 | |
| Not Available |
| Full Name | Rising Tide Licensed Clinical Social Worker A Professional Corp |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 249 Morning Sun Ave, Mill Valley, California |
| Authorized Official Name and Position | Lucas Michael Garrison (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3098683809 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Tide Licensed Clinical Social Worker A Professional Corp 249 Morning Sun Ave Mill Valley CA 94941-3503 Ph: (309) 868-3809 | Rising Tide Licensed Clinical Social Worker A Professional Corp 249 Morning Sun Ave Mill Valley CA 94941-3503 Ph: (309) 868-3809 |
| NPI Number | 1730007782 |
|---|---|
| Provider Enumeration Date | 07/08/2026 |
| Last Update Date | 07/08/2026 |
| Certification Date | 07/08/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730007782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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