Derrell R. Tidwell, LCSW

Clinical Social Worker · Port Townsend, WA

Individual Active NPI

NPI number 1871661074

Practice location

432 30TH Street
Port Townsend, WA 98368
Phone
(310) 670-4295

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NPI record

NPI
1871661074
Entity type
Individual (Type 1)
Enumeration date
December 4, 2006
Last updated
February 14, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 9609 CA

About Derrell Tidwell

Derrell R. Tidwell, LCSW is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 432 30TH Street, Port Townsend, WA 98368. The NPI number 1871661074 was assigned on December 4, 2006 and the record was last updated on February 14, 2024.

Derrell Tidwell lists a license in the registry: #9609 (CA) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Derrell R. Tidwell, LCSW?

The NPI number is 1871661074.

What is the phone number of Derrell Tidwell?

The phone number listed for the practice location is (310) 670-4295.

Where is Derrell Tidwell located?

432 30TH Street, Port Townsend, WA 98368.

What is the taxonomy code for Derrell Tidwell?

The primary taxonomy code is 1041C0700X – Clinical Social Worker.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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