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Organization
TIDES OF CHANGE THERAPY SERVICES PLLC
Active
Organization
TIDES OF CHANGE THERAPY SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLEIGH DAVIS WEAVER LCSW (MEMBER OWNER)
(804) 822-5073
Entity
Organization
Contact information
Practice address
300 W HARGETT ST UNIT 234, RALEIGH, NC 27601-1596
(984) 788-6570
(844) 861-1194
Mailing address
300 W HARGETT ST UNIT 234, RALEIGH, NC 27601-1596
(984) 788-6570
(844) 861-1194
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336293000
—
VA
Enumeration date
07/22/2021
Last updated
07/22/2021
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