Healthcare Provider Details

I. General information

NPI: 1063350189
Provider Name (Legal Business Name): TIDES COUNSELING & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 CABOT ST STE 4
BEVERLY MA
01915-5109
US

IV. Provider business mailing address

145 CABOT ST STE 4
BEVERLY MA
01915-5109
US

V. Phone/Fax

Practice location:
  • Phone: 978-222-9870
  • Fax:
Mailing address:
  • Phone: 978-222-9870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: REBECCA MORES
Title or Position: FOUNDER/PSYCHOTHERAPIST
Credential: LICSW
Phone: 508-333-7818