Tidal Counseling LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001498 Issued in CT

Legal business name

TIDAL COUNSELING LLC

Practice address

263 Main St
Suite 304
Old Saybrook, CT 06475-2326

Phone

(860) 876-7488

NPI assigned

Apr 22, 2015

Last updated

Apr 22, 2015By 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

Mrs. Emily Greene Reynolds, LPC

Title

Owner / Psychotherapist

Phone

(860) 876-7488

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1255728614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 MAIN ST",
            "address_2": "SUITE 304",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752326",
            "telephone_number": "860-876-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 MAIN ST",
            "address_2": "SUITE 304",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752326",
            "telephone_number": "860-876-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDAL COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "GREENE",
        "authorized_official_title_or_position": "OWNER / PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "860-876-7488",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Old Saybrook, CT
• Providers in Old Saybrook, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.