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General NPI Number Information
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NPI Number | 1578272522
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Entity Type | Organization
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Legal Business Name | CHANGING TIDES THERAPEUTIC COUNSELING INC.
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Dates
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Enumeration Date | 11/18/2022
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 10 PRINCE PL STE 201
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City | NEWBURYPORT
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State | MA
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Zip | 01950-2657
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Country | US
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Telephone | 978-478-7805
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Fax | 978-255-4305
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Provider Business Mailing Address
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Address Line | 16 THORNELL RD
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City | NEWTON
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State | NH
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Zip | 03858-3617
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Country | US
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Telephone | 978-478-8277
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CRISTINA CURRO
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Credential | LICSW
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Telephone | 978-478-7805
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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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