Active NPI
Owen Tidwell, LICSW
- Counselor
- Fall River, MA
National Provider Identifier
1730756800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 124273
- Practice address
- 261 Mount Pleasant St
Fall River, MA 02720-4317 - Phone
- (774) 309-1819
- NPI assigned
- Jun 8, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 224258 | MA | |
| Counselor | 101Y00000X | 124273 | MA | Primary |
Addresses
Primary practice location
261 Mount Pleasant St
Fall River, MA 02720-4317
Mailing address
661 Drift Rd
Westport, MA 02790-1235
Phone (508) 493-5518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211207001127 | MA | Practitioner - Clinical Social Worker | 7911397930 | Practice locations: Swansea, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
25 Market St
Suite 14
Swansea, MA 02777-3998
Phone (508) 493-5518
261 Mount Pleasant St
Fall River, MA 02720-4317
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 224258 | MA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1730756800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "661 DRIFT RD",
"city": "WESTPORT",
"state": "MA",
"postal_code": "027901235",
"telephone_number": "508-493-5518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "261 MOUNT PLEASANT ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027204317",
"telephone_number": "774-309-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDWELL",
"first_name": "OWEN",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-08",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "224258",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "124273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.