Provider Demographics
NPI:1508566258
Name:HEALING TIDES HEALTH AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:HEALING TIDES HEALTH AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN FNP PMHNP
Authorized Official - Phone:919-446-1302
Mailing Address - Street 1:1403 TARBERT DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5030
Mailing Address - Country:US
Mailing Address - Phone:919-444-1502
Mailing Address - Fax:
Practice Address - Street 1:1513 WALNUT ST STE 215
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5900
Practice Address - Country:US
Practice Address - Phone:919-446-1302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)