Changing Tides Counseling, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

CHANGING TIDES COUNSELING, LLC

Practice address

51 S Main Ave Ste 304
Clearwater, FL 33765-3937

Phone

(920) 370-7680

NPI assigned

Nov 8, 2022

Last updated

Nov 8, 2022By 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

Samantha Petroshius-Crocker, LMHCNPI 1295259265

Title

Owner/Manager

Phone

(813) 461-5370

Specialties & licenses 2

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, and the practitioner matching its NPPES authorized official.

• Samantha Petroshius-Crocker, LMHC

  • Mental Health Counselor
  • Clearwater, FL
  • NPI 1295259265
  NPD Authorized official

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1639887672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 S MAIN AVE STE 304",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653937",
            "telephone_number": "920-370-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 S MAIN AVE STE 304",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653937",
            "telephone_number": "920-370-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "PETROSHIUS-CROCKER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "813-461-5370",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21772400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Sidney Ford Chance, DC
• Bryce Chandler
• Manju Chandran
• Angela Denise Beal Chaney
• Changing Lives Counseling Services, LLC
• Liberato Chapa, MD
• Alfred B Chapman, D.O.
• Joseph Chapman, D.C.
• Laurie Ann Chappell, LSA, CST/CSFA
• Brian M Charity, DO

• Adolescent and Children Mental Health Clinic/Center in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.