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General NPI Number Information
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NPI Number | 1427698521
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Entity Type | Organization
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Legal Business Name | TURNING TIDES PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 650 BOULEVARD AVE
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City | DICKSON CITY
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State | PA
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Zip | 18519-1710
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Country | US
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Telephone | 570-209-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 650 BOULEVARD AVE
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City | DICKSON CITY
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State | PA
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Zip | 18519-1710
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Country | US
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Telephone | 570-209-9898
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Fax |
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Authorized Official
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Title or Position | OWNER/ PSYCHOLOGIST
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Name | DR. CAROLINE JOHANSON
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Credential | PH.D.
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Telephone | 570-209-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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