| Tidal Counseling, Plc | |
|
208 E Plume St Ste 327b Norfolk VA 23510-1757 | |
| (757) 637-0840 | |
| Not Available |
| Full Name | Tidal Counseling, Plc |
|---|---|
| Speciality | Counselor |
| Location | 208 E Plume St Ste 327b, Norfolk, Virginia |
| Authorized Official Name and Position | Ruth H Bybee (PRESIDENT) |
| Authorized Official Contact | 7574181131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidal Counseling, Plc 208 E Plume St Ste 327b Norfolk VA 23510-1757 Ph: (757) 637-0840 | Tidal Counseling, Plc 208 E Plume St Ste 327b Norfolk VA 23510-1757 Ph: (757) 637-0840 |
| NPI Number | 1245970664 |
|---|---|
| Provider Enumeration Date | 04/01/2022 |
| Last Update Date | 02/08/2024 |
| Certification Date | 02/08/2024 |
| Medicare PECOS PAC ID | 7012392053 |
|---|---|
| Medicare Enrollment ID | O20220912003356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245970664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Kristine B Rand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497029011 PECOS PAC ID: 9931341757 Enrollment ID: I20130807000630 |
| Provider Name | Rebecca T Waranch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437718988 PECOS PAC ID: 3870903370 Enrollment ID: I20201112001921 |
| Provider Name | Lucy Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598477721 PECOS PAC ID: 9739554411 Enrollment ID: I20230411001776 |
| Provider Name | Ruth Bybee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003493412 PECOS PAC ID: 4587049390 Enrollment ID: I20240216004203 |
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