Tidewater Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TIDEWATER THERAPY

Practice address

450 Park St
Rockport, ME 04856-5339

Phone

(207) 707-0769

NPI assigned

Jul 13, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Heather Gaylor, LCSW

Title

Owner

Phone

(207) 707-0769

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1783900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1033038252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PARK ST",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048565339",
            "telephone_number": "207-707-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PARK ST",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048565339",
            "telephone_number": "207-707-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "GAYLOR",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-707-0769",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randal Thivierge, DSS
• Elizabeth A Thompson, PA-C
• Holly S Thro, MD
• Mira-Su Thurston, PA-C
• Christina Lynn Tibbetts, R.D.H.
• Jana M Tobin, PT
• Sonja Tomic, M.D.
• Town of Rockport
• Elizabeth A Tulip, P.A.
• Matthew Turner, P.A.

• All providers in Rockport, ME
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.