Changing Tides Counseling Service, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CHANGING TIDES COUNSELING SERVICE, LLC

Practice address

209 W Jessamine Ave
Foley, AL 36535-2010

Phone

(205) 602-7365

NPI assigned

Feb 19, 2020

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Sanders, LICSWNPI 1669734174

Title

Sole Owner

Phone

(205) 602-7365

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 2

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.

• Jessica Lorraine Sanders, LCSW, PIP

  • Clinical Social Worker
  • Foley, AL
  • NPI 1669734174
  Medicare reassignment Care Compare group NPD Authorized official
• Joshua Williams, MSW, LICSW

  • Clinical Social Worker
  • Foley, AL
  • NPI 1043901895
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1205469061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 CYPRESS LAKE DR",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365429102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W JESSAMINE AVE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352010",
            "telephone_number": "205-602-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES COUNSELING SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "205-602-7365",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Foley, AL
• Providers in Foley, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.