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Contact Information

TIDEWATER RECOVERY, PLC
55 CROSS STREET
URBANNA, VA23175
 Phone: 804-758-4242
 Fax: 615-704-7447
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for TIDEWATER RECOVERY, PLC

NPI # 1396001855
LBN Legal business name TIDEWATER RECOVERY, PLC
Authorized official SUSAN HALLETT - (OWNER/THERAPIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/09/2012
Last updated 04/09/2012 - About 14 years ago
Identifiers
VA License # 0904005105
VA Other 1205910460 NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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