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General NPI Number Information
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NPI Number | 1255129813
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Entity Type | Organization
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Legal Business Name | TIDES EMOTIONAL HEALTH LLC
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 964 LAKESIDE DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-3404
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Country | US
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Telephone | 616-219-0782
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Fax |
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Provider Business Mailing Address
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Address Line | 1595 HILLSIDE DR
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City | OKEMOS
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State | MI
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Zip | 48864-2319
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER AND THERAPIST
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Name | HANNAH OLSON
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Credential | LCSW, LMSW
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Telephone | 616-219-0782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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