Organization Active NPI

Tideland Mental Health Center

  • Marriage & Family Therapist
  • Washington, NC
National Provider Identifier
1801806500
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
Practice address
1308 Highland Dr
Washington, NC 27889-3424
Phone
(252) 946-8061
Fax
(252) 946-8078
NPI assigned
Aug 8, 2006
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
Ms. Barbara R Moore
Title
Area Director
Phone
(252) 946-8061

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

1308 Highland Dr
Washington, NC 27889-3424

Mailing address

1308 Highland Dr
Washington, NC 27889-3424
Phone (252) 946-8061

Other identifiers 1

IdentifierTypeStateIssuer
6005470MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1801806500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 HIGHLAND DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893424",
            "telephone_number": "252-946-8061",
            "fax_number": "252-946-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 HIGHLAND DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893424",
            "telephone_number": "252-946-8061",
            "fax_number": "252-946-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDELAND MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "AREA DIRECTOR",
        "authorized_official_telephone_number": "252-946-8061",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005470",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, 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.