Tides of Totality Therapeutics Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TIDES OF TOTALITY THERAPEUTICS INC

Practice address

400 Central Ave Ste 250
Northfield, IL 60093-3024

Phone

(815) 505-0110

NPI assigned

Jan 11, 2025

Organization subpart

No

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

Authorized official

Name

Kristen Widing, LCSWNPI 1053959270

Title

Ceo

Phone

(815) 505-0110

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kristen Widing, LSW

  • Social Worker
  • Chicago, IL
  • NPI 1053959270
  NPD Authorized official

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

{
    "created_epoch": "1736553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736553600000",
    "number": "1891505848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 WARRINGTON LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE STE 250",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933024",
            "telephone_number": "815-505-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDES OF TOTALITY THERAPEUTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-11",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A",
        "authorized_official_last_name": "WIDING",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-505-0110",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Northfield, IL
• Providers in Northfield, IL by specialty
• Clinical Social Worker in Illinois

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