# CHANGING TIDES COUNSELING, LLC

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

## Provider details

- **NPI number:** 1639887672
- **Authorized official:** SAMANTHA PETROSHIUS-CROCKER LMHC (OWNER/MANAGER)
- **Authorized official phone:** (813) 461-5370

## Contact information

- **Practice address:** 51 S MAIN AVE STE 304, CLEARWATER, FL 33765-3937
- **Practice address phone:** (920) 370-7680
- **Mailing address:** 51 S MAIN AVE STE 304, CLEARWATER, FL 33765-3937
- **Mailing address phone:** (920) 370-7680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/08/2022
- **Last updated:** 11/08/2022