NPIMap

Organization Active NPI

Tideland Mental Health Center- Plymouth Office

  • Marriage & Family Therapist
  • Plymouth, NC
National Provider Identifier
1427187657
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
TIDELAND MENTAL HEALTH CENTER- PLYMOUTH OFFICE
Practice address
716 Washington St
Plymouth, NC 27962-2222
Phone
(252) 793-1154
Fax
(252) 793-3860
NPI assigned
Mar 5, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Barbara Moore
Title
Area Director
Phone
(252) 946-8061

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

716 Washington St
Plymouth, NC 27962-2222

Mailing address

716 Washington St
Plymouth, NC 27962-2222
Phone (252) 793-1154

Other identifiers 1

IdentifierTypeStateIssuer
8301499MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Tideland Mental Health Center- Columbia Office5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1427187657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 WASHINGTON ST",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279622222",
            "telephone_number": "252-793-1154",
            "fax_number": "252-793-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 WASHINGTON ST",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279622222",
            "telephone_number": "252-793-1154",
            "fax_number": "252-793-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDELAND MENTAL HEALTH CENTER- PLYMOUTH OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "AREA DIRECTOR",
        "authorized_official_telephone_number": "252-946-8061",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301499",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.