A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Clinical |
103TC0700X | 62 | Psychologist, Clinical | |
Addiction (Substance Use Disorder) |
103TA0400X | 62 | Psychologist, Clinical | |
Adult Development & Aging |
103TA0700X | 62 | Psychologist, Clinical | |
Clinical Child & Adolescent |
103TC2200X | 62 | Psychologist, Clinical | |
Cognitive & Behavioral |
103TB0200X | 62 | Psychologist, Clinical | |
Counseling |
103TC1900X | 62 | Psychologist, Clinical | |
Family |
103TF0000X | 62 | Psychologist, Clinical | |
Health |
103TH0004X | 62 | Psychologist, Clinical | |
Psychoanalysis |
103TP0814X | 62 | Psychologist, Clinical | |
Rehabilitation |
103TR0400X | 62 | Psychologist, Clinical |
| NPI Number | 1528856531 |
| LBN Legal business name | SOUL TIDE PSYCHOTHERAPY PC |
| Authorized official | TREVOR OLSON - (SECRETARY) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/29/2025 |
| Last updated | 07/30/2025 - About 10 months ago |
| Identifiers | n/a |
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