TIDELAND MENTAL HEALTH CENTER- MATT OPP


Address: 69 Church Street, Fairfield, NC 27826
Phone: 2529263731

TIDELAND MENTAL HEALTH CENTER- MATT OPP (NPI# 1053441782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053441782
Entity Type Organization
Organization Name TIDELAND MENTAL HEALTH CENTER- MATT OPP
Practice Address 69 Church Street
Fairfield
NC 27826
Mailing Address Po Box 36
Fairfield
NC 27826-0036
Practice Telephone 2529263731
Practice Fax Number 2529263213
Mailing Telephone 2529263731
Mailing Fax Number 2529263213
Enumeration Date 2007-03-06
Last Update Date 2020-08-22
Authorized Official Name MRS. BARBARA MOORE (AREA DIRECTOR)
Authorized Official Telephone 2529468061
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 101Y00000X Counselor Behavioral Health & Social Service Providers
X 101YP2500X Counselor
Specialization: Professional
Behavioral Health & Social Service Providers
X 1041C0700X Social Worker
Specialization: Clinical
Behavioral Health & Social Service Providers
X 106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers

Office Location

Street Address 69 CHURCH STREET
City FAIRFIELD
State NC
Zip Code 27826

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245469097 Hyde County Dss Mattamuskeet Opportunties Adap Center Day Training, Developmentally Disabled Services 69 Church St, Fairfield, NC 27826-9566 2009-07-14

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1982203592 Leahann Vedella Licensed Psychiatric Technician 2398 Flatley Cir, Fairfield, CA 94533-8921 2020-10-23
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1780283176 Karl Kochersperger Specialist/Technologist 146 Sherwood Farm Rd, Fairfield, CT 06824-2979 2020-10-18
1437757838 Tree of Life Centers Social Worker 191 Catherine Ter, Fairfield, CT 06824-6463 2020-10-16
1154929651 Shauntel Evette Haas Registered Nurse 2811 Toland Dr, Fairfield, CA 94534-3441 2020-10-15
1578161170 Lisa B Stein Nurse Practitioner 861 Brooklawn Ave, Fairfield, CT 06825-1809 2020-10-15
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629675624 Natasha A Ridosh Counselor 2750 N Texas St Unit 7206, Fairfield, CA 94533-1176 2020-10-03
1003424219 Amanda Kate Tubb Counselor 1601 Union Ave Apt 2, Fairfield, CA 94533-3731 2020-07-14
1447877964 Victoria Larrieu Sebourne Counselor 35 Montauk St, Fairfield, CT 06825-1606 2020-06-30
1851913305 Christian Vazquez Counselor 5114 Bickford Cir, Fairfield, CA 94533-6574 2020-05-07
1952923492 Lionesha Nashell Lewis Counselor 701 E Travis Blvd Apt 13, Fairfield, CA 94533-8754 2020-05-07
1922629971 Juan Carlos Cardenas Counselor 877 Sunset Ct, Fairfield, CA 94533-4145 2020-04-30
1518587013 Jaime Quesada Counselor 1357 Astoria Dr, Fairfield, CA 94534-4325 2020-04-24
1871113316 Scott D Wagner I Counselor 319 E Tabor Ave Apt 15319, Fairfield, CA 94533-3955 2020-04-24
1871113597 Krystal Hill Counselor 2999 N Texas St Apt 23, Fairfield, CA 94533-1283 2020-04-22
1922561232 Johnece M Smith Counselor 5010 Gary Ave, Fairfield, AL 35064-1349 2019-04-12
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Competitor

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City FAIRFIELD
Zip Code 27826

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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