PRINCESS TIDWELL (NPI# 1760984520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760984520 |
| Entity Type | Individual |
| Full Name | PRINCESS TIDWELL |
| Practice Address |
73 Holly Cv Mount Laurel NJ 08054-2823 |
| Practice Telephone | 8563083827 |
| Mailing Telephone | 8563083827 |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2018-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
73 HOLLY CV |
| City | MOUNT LAUREL |
| State | NJ |
| Zip Code | 08054-2823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837267 | Samantha Leafey | Behavior Technician | 800 Birchfield Dr., 801, Mount Laurel, NJ 08054 | 2019-12-04 |
| 1306403522 | A-1 Support Coordination Nj | Case Management | 1504 Larchmont Place, Mount Laurel, NJ 08054 | 2019-05-22 |
| 1285129080 | Lincoln Healthcare of New Jersey, LLC | Home Health | 309 Fellowship Rd Ste 100, Mount Laurel, NJ 08054 | 2018-06-25 |
| 1295238400 | Verus Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 200 E Park Dr Ste 600a, Mount Laurel, NJ 08054 | 2018-03-14 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1750893954 | Tishanna D Majette Phd Corporation | Psychologist | 3000 Atrium Way Ste 200, Mount Laurel, NJ 08054 | 2017-10-27 |
| 1700304706 | Arc of Camden County Essex Lane Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5320 Essex Lane, Mt. Laurel, NJ 08054 | 2017-08-30 |
| 1417472861 | Maggie Garin | Dietitian, Registered | 15000 Midlantic Avenue, Suite 101, Mount Laurel, NJ 08054 | 2017-08-07 |
| 1891225363 | New Jersey Lice Treatment LLC | Technician, Other | 500 Birchfield Dr, Suite 503-a, Mount Laurel, NJ 08054 | 2017-06-15 |
| 1225563927 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 761 Grant Ave, Mt Laurel, NJ 08054 | 2017-05-01 |
| Find all providers in zip 08054 | ||||
| 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 |
|---|---|---|---|---|
| 1295336006 | Jeffrey Noonan | Counselor | 3900 Church Rd, Mount Laurel, NJ 08054-1108 | 2020-11-06 |
| 1902405483 | The Chrysalis Counseling Center LLC | Counselor | 3000 Atrium Way Ste 200, Mount Laurel, NJ 08054-3910 | 2020-10-26 |
| 1922583608 | Leyla Bavi | Counselor | 15000 Midlantic Dr Ste 101, Mount Laurel, NJ 08054-1573 | 2018-09-28 |
| 1861995243 | Emily Capelli | Counselor | 15000 Midlantic Dr Ste 101, Mount Laurel, NJ 08054-1573 | 2018-03-13 |
| 1831397686 | About Life Counseling, LLC | Counselor | 9 Fulton Dr, Mount Laurel, NJ 08054-4510 | 2007-07-03 |
| 1285783357 | Integrative Training & Consulting, LLC | Counselor | 108 Fairway Ter, Mount Laurel, NJ 08054-2321 | 2007-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211330 | Allison Herman | Counselor | 85 Bay St Apt 2a, Montclair, NJ 07042-4847 | 2020-09-29 |
| 1558977884 | Kiki Tamika Black | Counselor | 603 Hamilton Rd, South Orange, NJ 07079-2709 | 2020-09-22 |
| 1003421124 | Kelli Aida Karver | Counselor | 854 Asbury Ave Fl 2, Ocean City, NJ 08226-3600 | 2020-09-15 |
| 1942815162 | Eleanor Leanna Holder-elcock | Counselor | 1326 Lake St, Plainfield, NJ 07060-3126 | 2020-09-14 |
| 1750996229 | Keith C Ross | Counselor | 186 Roosevelt Ave, Howell, NJ 07731-8542 | 2020-09-11 |
| 1821601055 | Marina Seunath | Counselor | 101 Mountain Ct, Hackettstown, NJ 07840-2300 | 2020-08-27 |
| 1467065870 | Miatta Brownson | Counselor | 522 Otto Ave, Edgewater Park, NJ 08010-2012 | 2020-08-25 |
| 1255941472 | Holistic Behavioral Solutions | Counselor | 65 S Main St Ste C001, Pennington, NJ 08534-2822 | 2020-08-03 |
| 1093323198 | Meaghan Isabel Murphy Donnelly | Counselor | 866 Wyoming Ave, Maywood, NJ 07607-1713 | 2020-07-15 |
| 1235757394 | Antonio Morais | Counselor | 99 Bayard St Bsmt 1, New Brunswick, NJ 08901-2184 | 2020-07-06 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT LAUREL |
| Zip Code | 08054 |
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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.