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General NPI Number Information
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NPI Number | 1386152791
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Entity Type | Organization
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Legal Business Name | CHANGING TIDES COUNSELING LLC
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Dates
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Enumeration Date | 01/19/2018
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 3047 E MAIN RD STE 6
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City | PORTSMOUTH
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State | RI
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Zip | 02871-4262
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Country | US
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Telephone | 401-941-5115
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Fax |
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Provider Business Mailing Address
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Address Line | 3047 E MAIN RD STE 6
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City | PORTSMOUTH
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State | RI
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Zip | 02871-4262
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Country | US
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Telephone | 401-941-5115
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | LORI SCHEFFLER
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Credential | LMHC, LCDP
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Telephone | 401-941-5115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MHC00840
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License Number State | RI
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