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General NPI Number Information
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NPI Number | 1013886464
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Entity Type | Organization
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Legal Business Name | WATERS EDGE PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1301 W EAU GALLIE BLVD
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City | MELBOURNE
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State | FL
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Zip | 32935-5398
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Country | US
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Telephone | 321-373-3744
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Fax |
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Provider Business Mailing Address
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Address Line | 451 SAINT JOHNS DR
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City | SATELLITE BEACH
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State | FL
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Zip | 32937-4023
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Country | US
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Telephone | 321-373-3744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CATHERINE A GALDA
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Credential | LCSW
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Telephone | 321-373-3744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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