TIDEWATER RECOVERY, PLC (NPI# 1396001855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396001855 |
| Entity Type | Organization |
| Organization Name | TIDEWATER RECOVERY, PLC |
| Practice Address |
55 Cross Street Urbanna VA 23175 |
| Mailing Address |
Po Box 1042 55 Cross Street Urbanna VA 23175-1042 |
| Practice Telephone | 8047584242 |
| Practice Fax Number | 6157047447 |
| Mailing Telephone | 8047584242 |
| Mailing Fax Number | 6157047447 |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |
| Authorized Official Name | MS. SUSAN G HALLETT (OWNER/THERAPIST) |
| Authorized Official Telephone | 8047584242 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
0904005105 | VA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | NPI | 1205910460 | 01 |
| Street Address |
55 CROSS STREET |
| City | URBANNA |
| State | VA |
| Zip Code | 23175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326533191 | Monica Durrette | Psychologist | 5342-a Old Virginia Street, Urbanna, VA 23175 | 2018-06-25 |
| 1083078935 | Rural Infant Services Program | Case Management | 535372 Old Virginia Street, B, Urbanna, VA 23175 | 2016-04-07 |
| 1437519907 | Katherine Elizabeth Wilson | Physical Therapist | 5372 B Old Virginia St, Urbanna, VA 23175 | 2016-02-26 |
| 1124450937 | Tiffany Anne Pittman | Case Manager/Care Coordinator | 5372b Old Virginia St, Urbanna, VA 23175 | 2013-08-02 |
| 1609102839 | Central Middlesex Volunteer Rescue Squad Inc | Ambulance | 391 Hilliard St, Urbanna, VA 23175 | 2009-10-22 |
| 1003011537 | Peak Performance Therapy LLC | Physical Therapist | 390 Virginia St, Urbanna, VA 23175 | 2007-06-15 |
| 1265565352 | Deborah Hare Whiteway | Speech-Language Pathologist | 5372 B Old Virginia Street, Urbanna, VA 23175 | 2007-03-14 |
| 1740311745 | Julie Ann Dobias | Physical Therapist | 5372-b Old Virginia Street, Urbanna, VA 23175 | 2007-03-08 |
| 1992879282 | Middle Peninsula-northern Neck Mental Health and Mental Retardation | Physical Therapist | 5372b Old Virginia Street, Urbanna, VA 23175 | 2006-11-20 |
| 1780656215 | Bay Aging | Public Health or Welfare | 5306 Old Virginia St., Urbanna, VA 23175 | 2006-02-07 |
| Find all providers in zip 23175 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205910460 | Susan G Hallett | Social Worker | 381 Virginia St, 200-a, Urbanna, VA 23175-2438 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780420 | Sharon Bixby | Social Worker | 10165 Meadows Rd, Locust Grove, VA 22508-9612 | 2020-11-08 |
| 1518568518 | Ruth Ilboudo | Social Worker | 15732 John Diskin Cir, Woodbridge, VA 22191-6550 | 2020-11-05 |
| 1639770597 | Tracy Ann Carroll | Social Worker | 16200 Saville Chase Ln, Midlothian, VA 23112-4585 | 2020-11-05 |
| 1801497037 | Miriam Matthews | Social Worker | 503 Arbre Ct, Virginia Beach, VA 23451-6001 | 2020-11-04 |
| 1215538475 | Yvonne Cotton | Social Worker | 3201 Churchland Blvd Suite 3, Chesapeake, VA 23321 | 2020-11-04 |
| 1932700382 | Caitlin Duggan | Social Worker | 5712 Oak Knoll Rd, Midlothian, VA 23112-2400 | 2020-11-03 |
| 1285234021 | Sabrina Kafin Weiskind | Social Worker | 13221 Point Pleasant Dr, Fairfax, VA 22033-3508 | 2020-10-30 |
| 1932709714 | Jennifer Lynn Sistrunk | Social Worker | 5608 Riverside Heights Way, Richmond, VA 23225-2478 | 2020-10-29 |
| 1841890027 | Heather D Hiner | Social Worker | 735 Sanhill Dr, Lynchburg, VA 24502-4923 | 2020-10-28 |
| 1518567627 | Emily Apkarian | Social Worker | 923 E Ocean View Ave, Norfolk, VA 23503-1909 | 2020-10-28 |
| Find all providers with the same taxonomy | ||||
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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.