Shifting Tides, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042029A Issued in IN

Legal business name

SHIFTING TIDES, LLC

Practice address

6337 Central Ave
Portage, IN 46368-3801

Phone

(219) 763-1499

Fax

(219) 764-7025

NPI assigned

Feb 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Todd Snyder, PSY.D.

Title

Operating Member

Phone

(219) 763-1499

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David W. Parks, PSY.D.

  • Clinical Psychologist
  • Portage, IN
  • NPI 1285702548
  NPD (past)
• Sara Veldhuizen, MS, LMHC

  • Mental Health Counselor
  • Portage, IN
  • NPI 1659819431
  NPD (past)
• Emily Waldo, MS, NCC, LMHC

  • Mental Health Counselor
  • Portage, IN
  • NPI 1043913932
  NPD (past)
• Carol Barbara Hillmann, PSY.D.

  • Clinical Psychologist
  • Spokane, WA
  • NPI 1326121781
  NPD (past)

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1194965392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6337 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683801",
            "telephone_number": "219-763-1499",
            "fax_number": "219-764-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683801",
            "telephone_number": "219-763-1499",
            "fax_number": "219-764-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFTING TIDES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-27",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OPERATING MEMBER",
        "authorized_official_telephone_number": "219-763-1499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042029A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200538700B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Select Medical Rehabilitation Clinics Inc
• Faizuddin Shareef, D.O
• Ashhad Sharif
• Emily C Shelton, CADC, CRSS
• Ashvin O Sheth, MSW
• Michelle Shough
• John Sikora, D.D.S.
• Silver LLC
• Spencer Simpson
• Sims Signature Personal Care LLC.

• Clinical Psychologist in Portage, IN
• Providers in Portage, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; 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.