NPIMap

Organization Active NPI

Tidelands Counseling

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1508107848
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT #39579 Issued in CA
Legal business name
TIDELANDS COUNSELING
Practice address
1411 Marsh St Ste 105
San Luis Obispo, CA 93401-2967
Phone
(805) 543-5060
Fax
(888) 364-3845
NPI assigned
Mar 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Authorized official

Name
Mr. Mat Chirman, MS, LMFT
Title
Owner
Phone
(805) 543-5060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X MFT #39579 CA Primary

Addresses

Primary practice location

1411 Marsh St Ste 105
San Luis Obispo, CA 93401-2967

Mailing address

1443 9TH St
Los Osos, CA 93402-1701
Phone (805) 543-5060

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1508107848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 9TH ST",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934021701",
            "telephone_number": "805-543-5060",
            "fax_number": "888-364-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MARSH ST STE 105",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012967",
            "telephone_number": "805-543-5060",
            "fax_number": "888-364-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDELANDS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "CHIRMAN",
        "authorized_official_first_name": "MAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-543-5060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT #39579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.