Tides of Change

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW10948 Issued in AZ

Legal business name

TIDES OF CHANGE

Practice address

333 W Wilcox Dr
Ste. 303
Sierra Vista, AZ 85635-1789

Phone

(520) 458-2250

Fax

(520) 458-2269

NPI assigned

Oct 26, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Marianne S Valladares, LCSWNPI 1275587412

Title

Ceo/Partner

Phone

(520) 458-2250

Specialties & licenses 7

Addresses

Tax ID family

Tides of Change2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tides of Change Center of Wellness

  • Community/Behavioral Health Agency
  • Sierra Vista, AZ
  • NPI 1376869321
  NPD tax ID

Locations

Practitioners 4

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

• Marianne S. Valladares, MSW, LCSW

  • Clinical Social Worker
  • Fort Gordon, GA
  • NPI 1275587412
  NPD (past) Authorized official
• Makisha Litten Gunty, LMSW

  • Social Worker
  • Sierra Vista, AZ
  • NPI 1033492947
  NPD (past)
• Candace Lynne Quibell, LCSW

  • Clinical Social Worker
  • Bisbee, AZ
  • NPI 1003032194
  NPD (past)
• Lorna G Sedillos, MSW

  • Clinical Social Worker
  • Sierra Vista, AZ
  • NPI 1295052579
  NPD (past)

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1811273568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W WILCOX DR",
            "address_2": "STE. 303",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856351789",
            "telephone_number": "520-458-2250",
            "fax_number": "520-458-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W WILCOX DR",
            "address_2": "STE. 303",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856351789",
            "telephone_number": "520-458-2250",
            "fax_number": "520-458-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDES OF CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "VALLADARES",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/PARTNER",
        "authorized_official_telephone_number": "520-458-2250",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC12687",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC10504",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW10948",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LMSW",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW12394",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "LCSW2922",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW2811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therapy Hut
• Thomas N Glow DPM PC
• Joseph C Thompson, D.O.
• Russell E Thompson, OD
• Patrick Donald Thurber, APRN
• Tides of Change Center of Wellness
• Kendie Sue Tilden, NURSE PRACTITIONER
• McKay Rees Tingey, PA-C
• Esther Toledo, REGISTERED NURSE
• Ana Rebecca Toothman, MA MFT

• Clinical Social Worker in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.