NPIMap

Organization Active NPI

Clinical Associates of Tidewater, P.C.

  • Clinical Psychologist
  • Norfolk, VA
National Provider Identifier
1124060314
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CLINICAL ASSOCIATES OF TIDEWATER, P.C.
Practice address
6320 N Center Dr
Suite 101
Norfolk, VA 23502-4009
Phone
(757) 456-0505
Fax
(757) 456-0817
NPI assigned
Jun 12, 2006
Last updated
Aug 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Authorized official

Name
Mrs. Rebecca Dean Reid, LCSWNPI 1922140136
Title
President
Phone
(757) 456-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

6320 N Center Dr
Suite 101
Norfolk, VA 23502-4009

Mailing address

6320 N Center Dr
Suite 101
Norfolk, VA 23502-4009
Phone (757) 456-0505

National Provider Directory

National Provider Directory

Locations

6320 N Center Dr
Ste 101
Norfolk, VA 23502
Phone (757) 456-0505

232 Business Park Dr
Ste 120
Virginia Beach, VA 23462
Phone (757) 456-0505

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1124060314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 N CENTER DR",
            "address_2": "SUITE 101",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024009",
            "telephone_number": "757-456-0505",
            "fax_number": "757-456-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 N CENTER DR",
            "address_2": "SUITE 101",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024009",
            "telephone_number": "757-456-0505",
            "fax_number": "757-456-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL ASSOCIATES OF TIDEWATER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-456-0505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.