Tides Wellness Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TIDES WELLNESS CENTER LLC

Practice address

617 Union Ave Ste 10
Brielle, NJ 08730-1838

Phone

(973) 464-6985

NPI assigned

Feb 12, 2021

Last updated

Feb 12, 2021By 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

Ms. Carolyn Artale, LCSWNPI 1538642574

Title

Ceo

Phone

(973) 464-6985

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Carolyn Artale, LCSW

  • Clinical Social Worker
  • Asbury Park, NJ
  • NPI 1538642574
  NPD Authorized official

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1245823160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 UNION AVE STE 10",
            "city": "BRIELLE",
            "state": "NJ",
            "postal_code": "087301838",
            "telephone_number": "973-464-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 UNION AVE STE 10",
            "city": "BRIELLE",
            "state": "NJ",
            "postal_code": "087301838",
            "telephone_number": "973-464-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDES WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "ARTALE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-464-6985",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Brielle, NJ
• Providers in Brielle, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.