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ELYSIA N TIDEY
NPI 1104541242
Counselor in South Bend, IN

Active since October 11, 2022
611 LINCOLN WAY E, SOUTH BEND, IN 46601(574) 360-4066(866) 843-2486 Get Directions Write a Review

NPPES record last updated: October 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Elysia N Tidey NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELYSIA N TIDEY (NPI 1104541242) is an individual counselor in South Bend, Indiana and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1104541242
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameELYSIA N TIDEY
Location Address611 LINCOLN WAY ESouth Bend, IN 46601-3212
Mailing Address611 Lincoln Way ESouth Bend, IN 46601-3212 · (574) 360-4066 · Fax (866) 843-2486
Phone(574) 360-4066
Fax(866) 843-2486
Sole ProprietorNo
Enumeration DateOctober 11, 2022
NPPES CertifiedOctober 11, 2022
✔ NPI 1104541242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
611 LINCOLN WAY E, South Bend, IN 46601
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEXANDRIA BURTON LSW
Social Worker
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 360-4066
MRS. RACHAEL MARIE HAMMETT PC
Social Worker (Clinical)
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 232-2255
LISA BALDERAS MA
Social Worker (Clinical)
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 232-2255
WENDY E SARVARI MS
Social Worker (Clinical)
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 232-2255
MICHELLE LYNN COUTO
Social Worker (Clinical)
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 360-4066
CAMIE TYLER MSW
Social Worker (Clinical)
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 232-2255
KARISSA D RYAN LMHC
Counselor (Mental Health)
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 360-4066
MR. RICHARD LAMAR WHITE JR. LSW
Social Worker
611 LINCOLN WAY E
SOUTH BEND, IN 46601
St. Joseph County (574) 360-4066

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elysia Tidey's NPI number?

The NPI number for Elysia Tidey is 1104541242. It was assigned to this individual provider in the NPPES registry on October 11, 2022.

Where is Elysia Tidey located?

Elysia Tidey practices at 611 Lincoln Way E, South Bend, IN 46601. The listed phone number is (574) 360-4066.

What is Elysia Tidey's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Elysia Tidey was last updated on October 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.