Healthcare Provider Details

I. General information

NPI: 1770418584
Provider Name (Legal Business Name): INNERMORE TIDES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 NANTASKET AVE UNIT A
HULL MA
02045-2521
US

IV. Provider business mailing address

534 NANTASKET AVE UNIT A
HULL MA
02045-2521
US

V. Phone/Fax

Practice location:
  • Phone: 978-430-7188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KATHARINE NIVEN
Title or Position: OWNER
Credential: LMHC
Phone: 978-430-7188