NPIMap

Organization Active NPI

Changing Tides Counseling and Wellness, LLC

Doing business as Sea Sparrow Counseling and Wellness, LLC

  • Clinical Social Worker
  • Homer, AK
National Provider Identifier
1982271508
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHANGING TIDES COUNSELING AND WELLNESS, LLC
Doing business as
Sea Sparrow Counseling and Wellness, LLC
Practice address
195 Cityview Ave Apt 1
Homer, AK 99603-7040
Phone
(907) 235-2102
NPI assigned
Jun 10, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Kimberly Wellness Glaspell, LCSWNPI 1346494200
Title
Therapist
Phone
(907) 235-2102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

195 Cityview Ave Apt 1
Homer, AK 99603-7040

Mailing address

195 Cityview Ave Apt 1
Homer, AK 99603-7040
Phone (907) 235-2102

Other names 1

  • Sea Sparrow Counseling and Wellness, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1982271508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 CITYVIEW AVE APT 1",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037040",
            "telephone_number": "907-235-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 CITYVIEW AVE APT 1",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037040",
            "telephone_number": "907-235-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES COUNSELING AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "GLASPELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "WELLNESS",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "907-235-2102",
        "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": [
        {
            "organization_name": "Sea Sparrow Counseling and Wellness, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.