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Organization

TIDEWATER PSYCHOTHERAPY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LOUISE FRIEDMAN LCSW (PRESIDENT, AUTHORIZAED OFFICAL)
(757) 497-3670
Entity
Organization

Contact information

Practice address
260 GRAYSON RD, SUITE 100, VIRGINIA BEACH, VA 23462-4345
(757) 497-3670
(757) 499-1947
Mailing address
260 GRAYSON RD, SUITE 100, VIRGINIA BEACH, VA 23462-4345
(757) 497-3670
(757) 499-1947

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
204
VA
104100000X
Social Worker
Primary
2006112732R
VA
2084P0800X
Psychiatry Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1700830742
VA
Enumeration date
05/22/2006
Last updated
08/21/2017
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