Healthcare Provider Details

I. General information

NPI: 1164317996
Provider Name (Legal Business Name): ONDA CALMA WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 BUOY LN
EAST LYME CT
06333-1777
US

IV. Provider business mailing address

PO BOX 143
EAST LYME CT
06333-0143
US

V. Phone/Fax

Practice location:
  • Phone: 401-315-4538
  • Fax:
Mailing address:
  • Phone: 401-315-4538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAY SOUZA-ERLANDSON
Title or Position: OWNER
Credential: LCSW
Phone: 401-315-4538