| Tides Counseling And Wellness, Pllc | |
|
2121 Eastchester Dr Ste 105 High Point NC 27265-1535 | |
| (336) 332-2277 | |
| Not Available |
| Full Name | Tides Counseling And Wellness, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2121 Eastchester Dr Ste 105, High Point, North Carolina |
| Authorized Official Name and Position | Charles Edward Hubert (LCSW) |
| Authorized Official Contact | 3363322277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tides Counseling And Wellness, Pllc 2121 Eastchester Dr Ste 105 High Point NC 27265-1535 Ph: (336) 332-2277 | Tides Counseling And Wellness, Pllc 2121 Eastchester Dr Ste 105 High Point NC 27265-1535 Ph: (336) 332-2277 |
| NPI Number | 1790357622 |
|---|---|
| Provider Enumeration Date | 07/12/2021 |
| Last Update Date | 10/11/2021 |
| Certification Date | 10/11/2021 |
| Medicare PECOS PAC ID | 5799175295 |
|---|---|
| Medicare Enrollment ID | O20211123002419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790357622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Charles Edward Hubert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821511759 PECOS PAC ID: 0648660142 Enrollment ID: I20211123002633 |
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