Organization · Type 2 NPI
Tidal Psychiatric Services LLC
Psychiatric/Mental Health Nurse Practitioner · St. Leonard, MD
NPI number
1174492342
Active
Practice location
7430 Mayflower Ct
St. Leonard, MD 20685-2497
Fax (540) 307-4943
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1174492342
Tidal Psychiatric Services LLC's National Provider Identifier is 1174492342, issued on Nov 4, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in St. Leonard, MD. The record was last updated on Nov 4, 2025.