Tideline Counseling and Mental Health Assocaites

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

TIDELINE COUNSELING AND MENTAL HEALTH ASSOCAITES

Practice address

100 Mariners Dr
Suite D
Kingsland, GA 31548-6666

Phone

(912) 276-3487

NPI assigned

Jan 4, 2016

Organization subpart

No

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

Authorized official

Name

Carol Knowles

Title

Cfo

Phone

(912) 276-3487

Specialties & licenses 1

Addresses

Other names 1

• Tideline Counseling and Mental Health Assocaites Doing business as

Locations

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1841656147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARINERS DR",
            "address_2": "SUITE D",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486666",
            "telephone_number": "912-276-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARINERS DR",
            "address_2": "SUITE D",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486666",
            "telephone_number": "912-276-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDELINE COUNSELING AND MENTAL HEALTH ASSOCAITES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-276-3487"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tideline Counseling and Mental Health Assocaites",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.