Tides of Change Therapy Services PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TIDES OF CHANGE THERAPY SERVICES PLLC

Practice address

300 W Hargett St Unit 234
Raleigh, NC 27601-1596

Phone

(984) 788-6570

Fax

(844) 861-1194

NPI assigned

Jul 22, 2021

Organization subpart

No

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

Authorized official

Name

Carleigh Davis Weaver, LCSWNPI 1649830860

Title

Member Owner

Phone

(804) 822-5073

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Carleigh Davis Weaver, LCSW

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1649830860
  NPD Authorized official

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1417520891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HARGETT ST UNIT 234",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011596",
            "telephone_number": "984-788-6570",
            "fax_number": "844-861-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HARGETT ST UNIT 234",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011596",
            "telephone_number": "984-788-6570",
            "fax_number": "844-861-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDES OF CHANGE THERAPY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "CARLEIGH",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "MEMBER OWNER",
        "authorized_official_telephone_number": "804-822-5073",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336293000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita D Thurman, M.S.
• Theresa Thurman
• Beverly Ann Thurmond, DDS
• Stephen R Tibbels, MD
• Tide Pool Counseling PLLC
• Sara Tiegreen, PH.D.
• Kelsie Tieman Overbey, LCSWA
• Julie Trainer Tiffany, M.D.
• Joseph Tigue, PA
• Christopher Joseph Tikvart, DDS

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

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