Healthcare Provider Details

I. General information

NPI: 1104543925
Provider Name (Legal Business Name): RISING TIDES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 N MAIN ST
CEDAR SPRINGS MI
49319-8041
US

IV. Provider business mailing address

261 N MAIN ST
CEDAR SPRINGS MI
49319-8041
US

V. Phone/Fax

Practice location:
  • Phone: 616-287-5637
  • Fax:
Mailing address:
  • Phone: 616-287-5637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ISABELLE MATTHEWS
Title or Position: OWNER
Credential: LMSW
Phone: 616-287-5637