Healthcare Provider Details

I. General information

NPI: 1295548865
Provider Name (Legal Business Name): 3RD WAVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 S ANGELL HEIGHTS DR
HURRICANE UT
84737-2380
US

IV. Provider business mailing address

1922 S ANGELL HEIGHTS DR
HURRICANE UT
84737-2380
US

V. Phone/Fax

Practice location:
  • Phone: 435-574-9217
  • Fax:
Mailing address:
  • Phone: 435-574-9217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL BRADLEY SIMPSON
Title or Position: OWNER
Credential: DSW, LCSW
Phone: 435-574-9217