# NEW TIDE PSYCHOTHERAPY

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

## Provider details

- **NPI number:** 1659986685
- **Authorized official:** ASHLYN BRADLEY LISW-CP (OWNER)
- **Authorized official phone:** (540) 538-5790

## Contact information

- **Practice address:** 753 JOHNNIE DODDS BLVD STE 100, MT PLEASANT, SC 29464-3054
- **Practice address phone:** (540) 538-5790
- **Mailing address:** 1425 LONG GROVE DR UNIT 304, MT PLEASANT, SC 29464-8422
- **Mailing address phone:** (540) 538-5790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 09/15/2020
- **Last updated:** 09/15/2020