Organization Active NPI

Ocean Waves Therapy LLC

  • Counseling Psychologist
  • Rehoboth Beach, DE
National Provider Identifier
1114790359
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
OCEAN WAVES THERAPY LLC
Practice address
36407 Fir Dr
Rehoboth Beach, DE 19971-8661
Phone
(302) 496-7116
NPI assigned
Oct 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ricky L Jones, LPCNPI 1780141432
Title
Ceo / LPC
Phone
(302) 496-7116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

36407 Fir Dr
Rehoboth Beach, DE 19971-8661

Mailing address

19266 Coastal Hwy Unit 4
Box68
Rehoboth Beach, DE 19971
Phone (302) 496-7116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240213000725 DE Part B Supplier - Clinic/Group Practice 6002259421 Receives reassigned benefits from 1 practitioner
Practice locations: Rehoboth Beach, DE

National Provider Directory

National Provider Directory

Locations

19266 Coastal Hwy
Unit 4
Rehoboth Beach, DE 19971

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1114790359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19266 COASTAL HWY UNIT 4",
            "address_2": "BOX68",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "19971",
            "telephone_number": "302-496-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36407 FIR DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199718661",
            "telephone_number": "302-496-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN WAVES THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO / LPC",
        "authorized_official_telephone_number": "302-496-7116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rehoboth Beach, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.