Provider Demographics
NPI:1194913863
Name:HEALING TIDES COUNSELING, LLC
Entity type:Organization
Organization Name:HEALING TIDES COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FINLEY-GASCOYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-306-9245
Mailing Address - Street 1:266 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3261
Mailing Address - Country:US
Mailing Address - Phone:203-306-9245
Mailing Address - Fax:
Practice Address - Street 1:266 BROAD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3261
Practice Address - Country:US
Practice Address - Phone:203-306-9245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty