Organization · NPI-2

Changing Tides Counseling & Behavioral Health, LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Oxon Hill, MD

NPI number1841859931
StatusActive
Last updated in NPPESApr 10, 2024

Details

NPI
1841859931
Entity type
Organization (NPI-2)
Legal business name
Changing Tides Counseling & Behavioral Health, LLC
Organization subpart
No
Enumeration date
Jun 11, 2019
Certification date
Apr 10, 2024
Last updated
Apr 10, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
1041C0700X Social Worker, Clinical––

Practice location

137 National Plz Ste 300
Oxon Hill, MD 20745-1153

Phone 240-273-3117

Mailing address

137 National Plz Ste 300
Oxon Hill, MD 20745-1153

Phone 301-327-1073

Authorized official

Kelly Jackson
Ceo
3013959033

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