Provider Demographics
NPI:1346067444
Name:TRANQUIL TIDES COUNSELING LLC
Entity type:Organization
Organization Name:TRANQUIL TIDES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LPC, NBCC
Authorized Official - Phone:360-291-7187
Mailing Address - Street 1:6400 NE HIGHWAY 99 STE G-171
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8799
Mailing Address - Country:US
Mailing Address - Phone:360-291-7187
Mailing Address - Fax:
Practice Address - Street 1:6400 NE HIGHWAY 99 STE G-171
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8799
Practice Address - Country:US
Practice Address - Phone:360-291-7187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)