Provider Demographics
NPI:1598488074
Name:RISING TIDE COUNSELING, PLLC
Entity Type:Organization
Organization Name:RISING TIDE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTRONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:910-356-6550
Mailing Address - Street 1:332 CATAMARAN RD
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-2505
Mailing Address - Country:US
Mailing Address - Phone:631-860-1168
Mailing Address - Fax:
Practice Address - Street 1:825 GUM BRANCH RD STE 138H
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6262
Practice Address - Country:US
Practice Address - Phone:910-356-6550
Practice Address - Fax:910-408-7408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty