| Organization Name: | TIDAL COUNSELING LLC |
| NPI Number: | 1255728614 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMILY GREENE REYNOLDS (OWNER / PSYCHOTHERAPIST) |
| Mailing Address: | 263 Main St Suite 304 Old Saybrook |
| State: | CT US |
| Postal Code: | 064752326 |
| Phone Number: | 8608767488 |
| Fax Number: | |
| NPI Enumeration Date: | 04/22/2015 |
| NPI Last Update Date: | 04/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001498 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |