Organization Active NPI

Tide and Branch Psychiatry LLC

  • Adult Mental Health Clinic/Center
  • Savannah, GA
National Provider Identifier
1679458566
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
TIDE AND BRANCH PSYCHIATRY LLC
Practice address
37 W Fairmont Ave Ste 317
Savannah, GA 31406-3458
Phone
(912) 216-2499
Fax
(866) 771-6261
NPI assigned
Aug 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Calysta Medley TilleyNPI 1770124026
Title
Co-Owner
Phone
(912) 216-2499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

37 W Fairmont Ave Ste 317
Savannah, GA 31406-3458

Mailing address

37 W Fairmont Ave Ste 317
Savannah, GA 31406-3458
Phone (912) 216-2499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260529000305 GA Part B Supplier - Clinic/Group Practice 4082184296 Receives reassigned benefits from 3 practitioners
Practice locations: Savannah, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2335677Tide and Branch Psychiatry37 W Fairmont Avenue, Suite 317, Savannah, GA 31406Certificate of waiverDec 15, 2027

National Provider Directory

National Provider Directory

Locations

37 W Fairmont Ave
Ste 317
Savannah, GA 31406
Phone (912) 925-8266

Practitioners & affiliated clinicians

Practitioners 3

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": "1754611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1679458566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 W FAIRMONT AVE STE 317",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063458",
            "telephone_number": "912-216-2499",
            "fax_number": "866-771-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 W FAIRMONT AVE STE 317",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063458",
            "telephone_number": "912-216-2499",
            "fax_number": "866-771-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDE AND BRANCH PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-08",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "CALYSTA",
        "authorized_official_middle_name": "MEDLEY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "912-216-2499"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.