BEVERLY TIDWELL (NPI# 1568828036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568828036 |
| Entity Type | Individual |
| Full Name | BEVERLY TIDWELL |
| Practice Address |
3780 Rosin Ct #110 Sacramento CA 95834-1646 |
| Practice Telephone | 9164410226 |
| Practice Fax Number | 9164410286 |
| Mailing Telephone | 9164410226 |
| Mailing Fax Number | 9164410286 |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
3780 ROSIN CT #110 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95834-1646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417178195 | Amanda Nugent Divine | Counselor | 3780 Rosin Ct, Suite 110, Sacramento, CA 95834-1646 | 2007-05-01 |
| 1043868458 | Keshia Lyons | Case Manager/Care Coordinator | 3780 Rosin Ct, Sacramento, CA 95834-1646 | 2019-08-28 |
| 1902460371 | Rachel Rose Cooper | Student in an Organized Health Care Education/Training Program | 3780 Rosin Ct, Sacramento, CA 95834-1646 | 2019-04-30 |
| 1154819480 | Alan J Coulter | Case Manager/Care Coordinator | 3780 Rosin Ct, Sacramento, CA 95834-1646 | 2018-04-23 |
| 1972036440 | Hassan Conteh | Licensed Vocational Nurse | 3780 Rosin Ct, Sacramento, CA 95834-1646 | 2017-04-11 |
| 1770024226 | Austin Santos | Case Manager/Care Coordinator | 3780 Rosin Ct, Suite 130, Sacramento, CA 95834-1646 | 2017-03-16 |
| 1013457548 | Deborah Nyanzu | Counselor | 3780 Rosin Ct, Suite 110, Sacramento, CA 95834-1646 | 2017-03-02 |
| 1871943357 | Karen Simmons | Counselor | 3780 Rosin Ct, Sacramento, CA 95834-1646 | 2016-06-15 |
| 1427441351 | Joshua Opena | Social Worker | 3780 Rosin Ct, Sacramento, CA 95834-1646 | 2015-03-17 |
| 1689083644 | El Hogar | Community/Behavioral Health | 3780 Rosin Ct, Sacramento, CA 95834-1646 | 2014-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871085209 | Yen T Tran | Student in an Organized Health Care Education/Training Program | 3810 Rosin Ct Suite 170, Sacramento, CA 95834 | 2018-06-01 |
| 1326557620 | Mariah N Calpo | Registered Nurse | 601 North Market, Sacramento, CA 95834 | 2017-09-29 |
| 1710400700 | Rose Medical Transportation | Driver | 4330 Natomas Central Dr, Sacramento, CA 95834 | 2017-07-20 |
| 1801319066 | Caitlin Janae Lluen | Physical Medicine & Rehabilitation | 1948 Del Paso Road Suite 135, Sacramento, CA 95834 | 2017-07-19 |
| 1083152169 | Irene Enriquez Ramos | Social Worker | 3627 Broadland Street, Sacramento, CA 95834 | 2017-02-08 |
| 1609322973 | Zachary Estrada | Student in an Organized Health Care Education/Training Program | 3780 Rosic Court, Ste 130, Sacramento, CA 95834 | 2016-08-28 |
| 1104287465 | Mark David Levine, Mbr | Psychiatry & Neurology | 3835 N. Freeway Blvd., Suite 100, Sacramento, CA 95834 | 2016-03-15 |
| 1376902767 | Peter Yang | Case Manager/Care Coordinator | 3870 Rosin Court Ste 130, Sacramento, CA 95834 | 2016-02-15 |
| 1346615739 | Renee Joyce Eckley Reinhardt | Nurse Practitioner | 4100 E Commerce Way Suite 100, Sacramento, CA 95834 | 2015-12-10 |
| 1558779454 | Hanh Tran I | Pharmacist | 3769 Broadland St, Sacramento, CA 95834 | 2014-07-24 |
| Find all providers in zip 95834 | ||||
| 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 |
|---|---|---|---|---|
| 1952909210 | Christopher Shirey | Counselor | 1618 Alhambra Blvd, Sacramento, CA 95816-7601 | 2020-10-09 |
| 1043824337 | Adonis R Johnson | Counselor | 2500 Marconi Ave, Sacramento, CA 95821-4853 | 2020-09-03 |
| 1528676160 | Hope Lynn Mulligan | Counselor | 2750 Sutterville Rd # Cottage1, Sacramento, CA 95820-1024 | 2020-07-20 |
| 1235756891 | Guneet Kaur | Counselor | 8247 E Stockton Blvd # 4, Sacramento, CA 95828-8200 | 2020-06-30 |
| 1073132635 | Gage Michael Smith | Counselor | 7055 Woodrick Way, Sacramento, CA 95842-2246 | 2020-04-14 |
| 1952935876 | Crystal S Nicholas | Counselor | 845 Fulton Ave Apt 1051, Sacramento, CA 95825-6434 | 2020-02-29 |
| 1255975827 | Molly Ritter | Counselor | 650 Bercut Dr Ste C, Sacramento, CA 95811-0100 | 2019-11-06 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1821642265 | Courtney Nelson | Counselor | 7818 Bardu Ln, Sacramento, CA 95829 | 2019-07-24 |
| 1669948212 | Micaela Badue | Counselor | 401 S St., Sacramento, CA 95811 | 2018-10-22 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95834 |
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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.