Organization
CLINICAL ASSOCIATES OF TIDEWATER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA DEAN REID LCSW (PRESIDENT)
(757) 456-0505
Entity
Organization
Contact information
Practice address
6320 N CENTER DR, SUITE 101, NORFOLK, VA 23502-4009
(757) 456-0505
(757) 456-0817
Mailing address
6320 N CENTER DR, SUITE 101, NORFOLK, VA 23502-4009
(757) 456-0505
(757) 456-0817
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216460
MARK YARHOUSE-ANTHEM
VA
01
—
322713
FRANK AIELLO,MD - ANTHEM
VA
05
—
6717951
—
VA
01
—
72702
REBECCA REID - ANTHEM
VA
01
—
72705
NANCY PASCHALL-ANTHEM
VA
05
—
7702451
—
VA
05
—
7704241
—
VA
05
—
7730667
—
VA
05
—
7761775
—
VA
05
—
8917124
—
VA
01
—
93140
CAROLYN JOHNSON-ANTHEM
VA
Enumeration date
06/12/2006
Last updated
08/02/2010
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