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TIDAL PSYCHIATRIC SERVICES LLC
NPI 1174492342
Nurse Practitioner - Psychiatric/Mental Health in Saint Leonard, MD

Active since November 04, 2025
7430 MAYFLOWER CT, SAINT LEONARD, MD 20685(850) 758-6321(540) 307-4943 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Tidal Psychiatric Services Llc NPPES

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

TIDAL PSYCHIATRIC SERVICES LLC (NPI 1174492342) is a healthcare organization registered as a psychiatric/mental health in Saint Leonard, Maryland and active in the NPI registry since November 2025. The organization lists Tsion M Mekonnen, Owner, as its authorized official.

NPPES Registry Identity

NPI1174492342
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameTIDAL PSYCHIATRIC SERVICES LLC
Location Address7430 MAYFLOWER CTSaint Leonard, MD 20685-2497
Mailing Address7430 Mayflower CtSaint Leonard, MD 20685-2497 · (850) 758-6321 · Fax (540) 307-4943
Phone(850) 758-6321
Fax(540) 307-4943
Organization SubpartNo
Authorized OfficialTsion M MekonnenOwner · (540) 527-5070
Enumeration DateNovember 4, 2025
NPPES CertifiedNovember 4, 2025
✔ NPI 1174492342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
7430 MAYFLOWER CT, Saint Leonard, MD 20685
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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)

Tidal Psychiatric Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Tidal Psychiatric Services LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tsion Mekonnen, PMHNP-BC
Nurse Practitioner
NPI 1992413264
7430 MAYFLOWER CT
Saint Leonard, MD 20685
(850) 758-6321
✔ PECOS✔ Accepts MedicareSame address

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 Tidal Psychiatric Services LLC's NPI number?

The NPI number for Tidal Psychiatric Services LLC is 1174492342. It was assigned to this organization in the NPPES registry on November 4, 2025.

Where is Tidal Psychiatric Services LLC located?

Tidal Psychiatric Services LLC is located at 7430 Mayflower Ct, Saint Leonard, MD 20685. The listed phone number is (850) 758-6321.

What is Tidal Psychiatric Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Tidal Psychiatric Services LLC enrolled in Medicare?

Yes. Tidal Psychiatric Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tidal Psychiatric Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Tidal Psychiatric Services LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Tidal Psychiatric Services LLC was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.