TIDELAND MENTAL HEALTH CENTER- PLYMOUTH OFFICE (NPI# 1427187657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427187657 |
| Entity Type | Organization |
| Organization Name | TIDELAND MENTAL HEALTH CENTER- PLYMOUTH OFFICE |
| Practice Address |
716 Washington St Plymouth NC 27962-2222 |
| Practice Telephone | 2527931154 |
| Practice Fax Number | 2527933860 |
| Mailing Telephone | 2527931154 |
| Mailing Fax Number | 2527933860 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. BARBARA MOORE (AREA DIRECTOR) |
| Authorized Official Telephone | 2529468061 |
| Is Organization Subpart | N |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8301499 | 05 |
| Street Address |
716 WASHINGTON ST |
| City | PLYMOUTH |
| State | NC |
| Zip Code | 27962-2222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144555095 | Melissa Pledger | Pharmacist | 11 Us Hwy 64 E, Plymouth, NC 27962 | 2009-10-09 |
| 1356569651 | East Carolina Foot and Ankle Specialists | Podiatrist | 958 Hwy 64 East, Plymouth, NC 27962 | 2007-04-23 |
| 1659413581 | Changing Hearts Instead of Losing Lives, Inc | Community/Behavioral Health | 713 Forest Road, Plymouth, NC 27962 | 2007-02-14 |
| 1205934171 | Womble Drug Store | Pharmacy | 454 Hwy 64 East, Plymouth, NC 27962 | 2006-09-21 |
| 1184720054 | June Elizabeth Woolard | Social Worker | 206 Waters Street, Plymouth, NC 27962 | 2006-09-16 |
| 1285736470 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 734 Us 64 East, Plymouth, NC 27962 | 2006-09-01 |
| 1376568550 | Viswanathan Swaminathan | Psychiatry & Neurology | 804.washington Street, Vidant Behaviour Health, Plymouthy, NC 27962 | 2006-07-12 |
| 1144253758 | Jean Louis Pare | Family Medicine | 1006 Us Hwy 64 East, Plymouth, NC 27962 | 2006-07-08 |
| 1619907227 | Chester Lee Conner | Dentist | 363 Highway 64 West, Plymouth, NC 27962 | 2006-07-03 |
| 1750336855 | Robert Lee Venable | General Practice | 1004 Hwy 64 East, Plymouth, NC 27962 | 2006-05-24 |
| Find all providers in zip 27962 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487272787 | Alec Medeiros | Counselor | 16 Chickadee Way, Plymouth, MA 02360-1659 | 2020-07-13 |
| 1215569991 | Jessica Lynn Payne | Counselor | 260 S Union St, Plymouth, MI 48170-1612 | 2020-02-10 |
| 1699316117 | Kevin Louis Avitabile | Counselor | 62 Nautical Way, Plymouth, MA 02360-8611 | 2019-10-06 |
| 1194383323 | Passera Counseling, Pllc | Counselor | 42327 Ann Arbor Rd E, Plymouth, MI 48170-4356 | 2019-06-03 |
| 1316439763 | Aman Patel | Counselor | 200 Carver Rd, Plymouth, MA 02360-5210 | 2018-06-01 |
| 1255867230 | Sandra Somerville | Counselor | 933 Long Pond Rd, Plymouth, MA 02360-2635 | 2017-05-11 |
| 1346797438 | Barbara Lydon | Counselor | 118 Long Pond Rd Ste 106, Plymouth, MA 02360-2662 | 2016-09-06 |
| 1679020234 | Lisa Stringer | Counselor | 22 Jasons Lane, Plymouth, MA 02360 | 2016-09-01 |
| 1194173948 | William David Hunt IIi | Counselor | 164 Raymond Rd, Plymouth, MA 02360-2357 | 2016-06-01 |
| 1972959872 | Gregory Dominick Sorensen | Counselor | 18 Hopkins Road, Plymouth, MA 02360-3547 | 2016-05-10 |
| Find all providers in PLYMOUTH | ||||
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| 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.