Organization Active NPI

Healing Tides Counseling LLC

  • Mental Health Counselor
  • Kenai, AK
National Provider Identifier
1104698083
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HEALING TIDES COUNSELING LLC
Practice address
215 Fidalgo Ave
Kenai, AK 99611-7776
Phone
(907) 744-7969
Fax
(907) 206-7194
NPI assigned
Oct 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Micha Savage
Title
Manager
Phone
(208) 724-7237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

215 Fidalgo Ave
Kenai, AK 99611-7776

Mailing address

1515 Wedgewood Dr
Kenai, AK 99611-6636
Phone (907) 744-7969

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1104698083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 WEDGEWOOD DR",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116636",
            "telephone_number": "907-744-7969",
            "fax_number": "907-206-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 FIDALGO AVE",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117776",
            "telephone_number": "907-744-7969",
            "fax_number": "907-206-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING TIDES COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "SAVAGE",
        "authorized_official_first_name": "MICHA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-724-7237"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.