Blue Waves Therapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLUE WAVES THERAPY LLC

Practice address

4111E Rose Lake Dr # 7888
Charlotte, NC 28217-2858

Phone

(828) 278-8262

NPI assigned

Jan 22, 2025

Organization subpart

No

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

Authorized official

Name

Danielle KimNPI 1861993511

Title

Owner

Phone

(828) 448-4366

Specialties & licenses 1

Addresses

Practitioners 1

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

• Danielle P. Kim, LHMHC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1861993511
  NPD Authorized official

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

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1326850801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5466 AZALEA TRCE",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351736320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111E ROSE LAKE DR # 7888",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172858",
            "telephone_number": "828-278-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WAVES THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-448-4366"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jane Bludov, CRNA
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• Edna Renee Blue, MSW, LCSWA
• Omoyemen Osiwi Blue, MD
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• Bluedot Cares

• Mental Health Clinic/Center (Including Community Mental Health Center) in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.