Organization
CHANGING TIDES COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA PETROSHIUS-CROCKER LMHC (OWNER/MANAGER)
(813) 461-5370
Entity
Organization
Contact information
Practice address
51 S MAIN AVE STE 304, CLEARWATER, FL 33765-3937
(920) 370-7680
Mailing address
51 S MAIN AVE STE 304, CLEARWATER, FL 33765-3937
(920) 370-7680
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21772400
—
FL
Enumeration date
11/08/2022
Last updated
11/08/2022
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