Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidewater Mental Health Counseling PLLC

Organization Mental Health Clinic/Center (Including Community Mental Health Center) · NPI 1497556088

Tidewater Mental Health Counseling PLLC is a Mental Health Clinic/Center (Including Community Mental Health Center) in Huntington Station, New York. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

172 W 21st St
Huntington Station, NY 11746-2122
Phone: (484) 599-1580
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X

Record details

NPI number1497556088
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacquelyn Jackson — Owner · (484) 599-1580
NPI enumeratedMarch 20, 2025
Last updated in NPPESMarch 20, 2025
Certification dateMarch 20, 2025
Mailing address172 W 21st St, Huntington Station, NY 11746-2122

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