# TIDELAND MENTAL HEALTH CENTER- PLYMOUTH OFFICE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1427187657
- **Authorized official:** MRS. BARBARA MOORE (AREA DIRECTOR)
- **Authorized official phone:** (252) 946-8061

## Contact information

- **Practice address:** 716 WASHINGTON ST, PLYMOUTH, NC 27962-2222
- **Practice address phone:** (252) 793-1154
- **Practice address fax:** (252) 793-3860
- **Mailing address:** 716 WASHINGTON ST, PLYMOUTH, NC 27962-2222
- **Mailing address phone:** (252) 793-1154
- **Mailing address fax:** (252) 793-3860

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 09/11/2025