DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: THIRD WAVE PSYCHOTHERAPY, PLLC

MEDICARE: THIRD WAVE PSYCHOTHERAPY, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC007721NC

General Provider Information

NPI Number : 1205219763
Entity Type Code : Organization
Provider Name (Legal Business Name) : THIRD WAVE PSYCHOTHERAPY, PLLC
Provider Business Mailing Address
First Line : 5401 SIX FORKS RD STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27609-4462
Country : US
Telephone Number : 919-886-4052
Fax Number :
Provider Business Practice Location Address
First Line : 5401 SIX FORKS RD STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27609-4462
Country : US
Telephone Number : 919-886-4052
Fax Number :
Authorized Official
Title or Position : OWNER
Name : BRYAN LANDAAS
Credential : LCSW
Telephone Number : 919-923-8752
Provider Enumeration Date : 07/02/2015
Last Update Date : 01/04/2022

Similar Medicare Providers

1396092326 — MICHAEL SCOTT EASON LPC
Practice Location Address:
5401 SIX FORKS RD STE 200
RALEIGH, NC
27609-4462
Practice Phone: 919-886-4052
Practice Fax:
1346585304 — AMY DIANE SCHERE P.T., LCSWA
Practice Location Address:
5401 SIX FORKS RD STE 200
RALEIGH, NC
27609-4462
Practice Phone: 919-886-4052
Practice Fax:
1013508290 — TRIA SMOTHERS LCMHC-A
Practice Location Address:
5401 SIX FORKS RD
RALEIGH, NC
27609-4462
Practice Phone: 919-886-4052
Practice Fax:
1447827498 — ZACHARY QUIN UFLAND
Practice Location Address:
5401 SIX FORKS RD STE 200
RALEIGH, NC
27609-4462
Practice Phone: 919-886-4052
Practice Fax:
1063159754 — HALLIE BARNHILL
Practice Location Address:
5401 SIX FORKS RD STE 200
RALEIGH, NC
27609-4462
Practice Phone: 919-886-4052
Practice Fax:
1003546995 — JESSICA WHALEN
Practice Location Address:
5401 SIX FORKS RD STE 200
RALEIGH, NC
27609-4462
Practice Phone: 919-886-4052
Practice Fax:

Directions to “THIRD WAVE PSYCHOTHERAPY, PLLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.