Healthcare Provider Details

I. General information

NPI: 1205756459
Provider Name (Legal Business Name): ONDA HARBOR COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 BUOY LN
EAST LYME CT
06333-1777
US

IV. Provider business mailing address

205 BUOY LN
EAST LYME CT
06333-1777
US

V. Phone/Fax

Practice location:
  • Phone: 860-383-9470
  • Fax: 959-777-3468
Mailing address:
  • Phone: 860-383-9470
  • Fax: 959-777-3468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAY EDWARD SOUZA-ERLANDSON
Title or Position: SOLE PROPRIETOR
Credential: LCSW
Phone: 860-383-9470