# LIFE TIDE COUNSELING PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316205354
- **Authorized official:** MRS. CAROL A. SHEPARD LMFT (PRESIDENT)
- **Authorized official phone:** (910) 326-8881

## Contact information

- **Practice address:** 205 WARD RD, SUITE 1, SWANSBORO, NC 28584-8259
- **Practice address phone:** (910) 326-8881
- **Practice address fax:** (910) 326-2342
- **Mailing address:** PO BOX 1216, SWANSBORO, NC 28584-1216
- **Mailing address phone:** (910) 326-8881
- **Mailing address fax:** (910) 326-2342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 755 | NC | Yes |

## Other

- **Enumeration date:** 04/27/2012
- **Last updated:** 04/27/2012