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General NPI Number Information
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NPI Number | 1811886773
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Entity Type | Organization
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Legal Business Name | WAVE BEHAVIORAL HEALTH & PSYCHOTHERAPY PC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 6731 WHITTIER AVE STE B-250
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City | MC LEAN
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State | VA
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Zip | 22101-4525
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Country | US
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Telephone | 415-518-0646
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Fax |
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Provider Business Mailing Address
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Address Line | 6731 WHITTIER AVE STE B-250
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City | MC LEAN
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State | VA
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Zip | 22101-4525
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP CLINICAL OPERATIONS
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Name | MEGAN MURK
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Credential |
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Telephone | 415-518-0646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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