1. Home
  2. Directory
  3. New York
  4. Huntington Station
  5. Clinic Center
  6. NPI Profile

TIDEWATER MENTAL HEALTH COUNSELING PLLC
NPI 1497556088
Clinic/Center - Mental Health (Including Community Mental Health Center) in Huntington Station, NY

Active since March 20, 2025
172 W 21ST ST, HUNTINGTON STATION, NY 11746(484) 599-1580 Get Directions Write a Review

NPPES record last updated: March 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tidewater Mental Health Counseling Pllc NPPES

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

TIDEWATER MENTAL HEALTH COUNSELING PLLC (NPI 1497556088) is a healthcare organization registered as a mental health (including community mental health center) in Huntington Station, New York and active in the NPI registry since March 2025. The organization lists Jacquelyn Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1497556088
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameTIDEWATER MENTAL HEALTH COUNSELING PLLC
Location Address172 W 21ST STHuntington Station, NY 11746-2122
Mailing Address172 W 21st StHuntington Station, NY 11746-2122 · (484) 599-1580
Phone(484) 599-1580
Organization SubpartNo
Authorized OfficialJacquelyn JacksonOwner · (484) 599-1580
Enumeration DateMarch 20, 2025
NPPES CertifiedMarch 20, 2025
✔ NPI 1497556088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
172 W 21ST ST, Huntington Station, NY 11746
Open in Google Maps ↗

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 Tidewater Mental Health Counseling PLLC's NPI number?

The NPI number for Tidewater Mental Health Counseling PLLC is 1497556088. It was assigned to this organization in the NPPES registry on March 20, 2025.

Where is Tidewater Mental Health Counseling PLLC located?

Tidewater Mental Health Counseling PLLC is located at 172 W 21st St, Huntington Station, NY 11746. The listed phone number is (484) 599-1580.

What is Tidewater Mental Health Counseling PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Tidewater Mental Health Counseling PLLC was last updated on March 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.