Healthcare Provider Details

I. General information

NPI: 1396674016
Provider Name (Legal Business Name): NEXT WAVE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 CAMPUS DR STE 150
NEWPORT BEACH CA
92660-1931
US

IV. Provider business mailing address

4100 CAMPUS DR STE 150
NEWPORT BEACH CA
92660-1931
US

V. Phone/Fax

Practice location:
  • Phone: 949-919-0528
  • Fax:
Mailing address:
  • Phone: 949-919-0528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KYLE HARWICK
Title or Position: THERAPIST
Credential: LMFT
Phone: 949-919-0528