Organization
CLINICAL ASSOCIATES OF TIDEWATER, P.C.
Active
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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