Provider Demographics
NPI:1386152791
Name:CHANGING TIDES COUNSELING LLC
Entity type:Organization
Organization Name:CHANGING TIDES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LCDP
Authorized Official - Phone:401-941-5115
Mailing Address - Street 1:3047 E MAIN RD STE 6
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4262
Mailing Address - Country:US
Mailing Address - Phone:401-941-5115
Mailing Address - Fax:
Practice Address - Street 1:3047 E MAIN RD STE 6
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4262
Practice Address - Country:US
Practice Address - Phone:401-941-5115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00840101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty