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Organization
TIDEMARK BEHAVIORAL HEALTH
Active
Organization
TIDEMARK BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYNE LAXTON LCSW-C (CEO)
(484) 432-7882
Entity
Organization
Contact information
Practice address
1272 DELMAR AVE, WEST CHESTER, PA 19380-4027
(484) 432-7882
Mailing address
13 RYAN FROST WAY, ESSEX, MD 21221-1646
(484) 432-7882
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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