Healthcare Provider Details
I. General information
NPI: 1174452759
Provider Name (Legal Business Name): WAVES TO ANCHOR COUNSELING, LLC
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
138 EAST ST
BRIDGEWATER MA
02324-2074
US
IV. Provider business mailing address
138 EAST ST
BRIDGEWATER MA
02324-2074
US
V. Phone/Fax
- Phone: 617-615-5017
- Fax:
- Phone: 617-615-5017
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MCKENZIE
ESPERO
Title or Position: OWNER
Credential: LMHC
Phone: 617-615-5017