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General NPI Number Information
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NPI Number | 1609468172
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Entity Type | Organization
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Legal Business Name | CALM BLUE WATERS COUNSELING, PLLC
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Dates
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Enumeration Date | 02/06/2021
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Last Update Date | 02/06/2021
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Provider Practice Location Address
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Address Line | 13420 REESE BLVD W
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7925
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Country | US
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Telephone | 980-689-1794
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Fax | 704-464-4782
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Provider Business Mailing Address
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Address Line | 13420 REESE BLVD W
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7925
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Country | US
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Telephone | 980-689-1794
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Fax | 704-464-4782
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Authorized Official
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Title or Position | CLINICAL MENTAL HEATH COUNSELOR
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Name | MRS. AMY NICOLE CASTONGIA
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Credential | NCC, BC-TMH, LCMHC,
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Telephone | 980-689-1794
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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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