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Organization

TIDAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELSEY BALL LCPC (OWNER)
(316) 308-5426
Entity
Organization

Contact information

Practice address
5005 N EMERALD CT, MAIZE, KS 67101-8717
(316) 308-5426
Mailing address
5005 N EMERALD CT, MAIZE, KS 67101-8717

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
10/24/2025
Last updated
10/24/2025
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