Tida Healthcare LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

TIDA HEALTHCARE LLC

Practice address

2209 Montauk Dr
Crofton, MD 21114-3245

Phone

(443) 570-7610

NPI assigned

Apr 19, 2022

Organization subpart

No

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

Authorized official

Name

Ida Konchou, CRNP

Title

Ceo

Phone

(443) 570-7610

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1902549728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 MONTAUK DR",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211143245",
            "telephone_number": "443-570-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 MONTAUK DR",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211143245",
            "telephone_number": "443-570-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "KONCHOU",
        "authorized_official_first_name": "IDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-570-7610",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kemmesha Latrice Thomas
• Nirmala Thomas, CRNP
• Sophia Thompson
• Thrive Counseling Teletherapy Services LLC (Thrive Counseling Teletherapy Services)
• Tida Healthcare LLC
• Amy Lynn Titus
• Penny Todd, M.AC., L.AC.
• Lucero Paras Topete, BEHAVIOR TECHNICIAN
• Total Family Care LLC (Simita Udaya Talwar, M.D.)
• Erin H Traweek

• Psychiatry Physician in Crofton, MD
• Providers in Crofton, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.