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Organization
TIDE POOL COUNSELING PLLC
Active
Organization
TIDE POOL COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADELINE PAIGE BONNER MSW, LCSW (OWNER)
(919) 667-8789
Entity
Organization
Contact information
Practice address
5561 MCNEELY DR STE 101, RALEIGH, NC 27612-7625
(984) 305-3141
Mailing address
5561 MCNEELY DR STE 101, RALEIGH, NC 27612-7625
(984) 305-3141
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/07/2023
Last updated
01/30/2024
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