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General NPI Number Information
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NPI Number | 1235873571
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Entity Type | Organization
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Legal Business Name | WAVES OF CHANGE COUNSELING, LLC
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 8414 FARM RD STE 180-324
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City | LAS VEGAS
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State | NV
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Zip | 89131-8170
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Country | US
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Telephone | 702-518-3592
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Fax |
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Provider Business Mailing Address
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Address Line | 8414 FARM RD STE 180-324
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City | LAS VEGAS
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State | NV
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Zip | 89131-8170
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Country | US
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Telephone | 702-518-3592
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERICA HUNTER
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Credential | LCSW
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Telephone | 702-518-3592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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