Breakwater Therapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BREAKWATER THERAPY, PLLC

Practice address

330 Military Cutoff Rd Ste A4
Wilmington, NC 28405-8303

Phone

(252) 229-7956

NPI assigned

Apr 3, 2023

Last updated

Apr 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sierra Davis, MSW, LCSW, LCAS

Title

Owner

Phone

(252) 229-7956

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1205531852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5741 HIGHGROVE PL",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284094257",
            "telephone_number": "252-229-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MILITARY CUTOFF RD STE A4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284058303",
            "telephone_number": "252-229-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKWATER THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SIERRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-229-7956",
        "authorized_official_credential": "MSW, LCSW, LCAS"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.