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TIDES MENTAL HEALTH OF IL, PLLC
NPI 1154014116
Social Worker - Clinical in Chicago, IL

Active since May 26, 2023
3000 N HALSTED ST STE 803, CHICAGO, IL 60657(312) 391-6845 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 19, 2024, May 26, 2023 (2 updates tracked since 2023).

About Tides Mental Health Of Il, Pllc NPPES

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

TIDES MENTAL HEALTH OF IL, PLLC (NPI 1154014116) is a healthcare organization registered as a clinical in Chicago, Illinois and active in the NPI registry since May 2023. The organization lists Reginald Richardson, Owner, as its authorized official.

NPPES Registry Identity

NPI1154014116
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameTIDES MENTAL HEALTH OF IL, PLLC
Location Address3000 N HALSTED ST STE 803Chicago, IL 60657-6185
Mailing Address3000 N Halsted St Ste 803Chicago, IL 60657-6185 · (312) 391-6845
Phone(312) 391-6845
Organization SubpartNo
Authorized OfficialReginald RichardsonOwner · (312) 391-6845
Enumeration DateMay 26, 2023
Last NPPES UpdateDecember 19, 20242 updates tracked since enumeration
NPPES CertifiedDecember 19, 2024
✔ NPI 1154014116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedMarriage & Family TherapistTaxonomy 106H00000X
3000 N HALSTED ST STE 803, Chicago, IL 60657
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tides Mental Health Of Il, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Tides Mental Health Of Il, PLLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Erica Bohac
Clinical Social Worker
NPI 1760356968
3000 N HALSTED ST STE 803
Chicago, IL 60657
(312) 391-6845
✔ PECOSSame address
Joseph Beeman, CRNP
Nurse Practitioner
NPI 1518508837
3000 N HALSTED ST STE 803
Chicago, IL 60657
(312) 376-1665
✔ PECOS✔ Accepts MedicareSame address
Olivia Davis
Nurse Practitioner
NPI 1801639091
3000 N HALSTED ST STE 803
Chicago, IL 60657
(312) 376-1665
✔ PECOS✔ Accepts MedicareSame address
Sarah Beerman, LCSW
Clinical Social Worker
NPI 1366067423
3665 N BROADWAY ST
Chicago, IL 60613
(773) 496-4433
✔ PECOS✔ Accepts Medicare0.8 mi
Ryan Watters, LSW
Clinical Social Worker
NPI 1174255103
1 E SUPERIOR ST STE 306
Chicago, IL 60611
(312) 754-9404
✔ PECOS✔ Accepts Medicare3.4 mi
Reginald Richardson, PH.D.
Clinical Social Worker
NPI 1508904962
618 LIBRARY PL
Evanston, IL 60201
(847) 733-4300
✔ PECOS✔ Accepts Medicare8.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Tides Mental Health Of Il, PLLC's NPI number?

The NPI number for Tides Mental Health Of Il, PLLC is 1154014116. It was assigned to this organization in the NPPES registry on May 26, 2023.

Where is Tides Mental Health Of Il, PLLC located?

Tides Mental Health Of Il, PLLC is located at 3000 N Halsted St Ste 803, Chicago, IL 60657. The listed phone number is (312) 391-6845.

What is Tides Mental Health Of Il, PLLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Tides Mental Health Of Il, PLLC enrolled in Medicare?

Yes. Tides Mental Health Of Il, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tides Mental Health Of Il, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Tides Mental Health Of Il, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (4) and Nurse Practitioner (2). Of these, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Tides Mental Health Of Il, PLLC was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.