Wave Professional Clinical Counselors Inc.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

46057 Issued in CA

Legal business name

WAVE PROFESSIONAL CLINICAL COUNSELORS INC.

Practice address

1207 Carlsbad Village Dr
Suite Q
Carlsbad, CA 92008-1957

Phone

(760) 500-3325

NPI assigned

Apr 29, 2015

Organization subpart

No

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

Authorized official

Name

Mark BrewerNPI 1023154358

Title

Owner

Phone

(760) 500-3325

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Wave Professional Clinical Counselors, Inc.

  • Community/Behavioral Health Agency
  • Carlsbad, CA
  • NPI 1700288768

  O20150911000030

  Same enrollment

Locations

Practitioners 1

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

• Mark C. Brewer, MFT

  • Marriage & Family Therapist
  • Carlsbad, CA
  • NPI 1023154358
  NPD Authorized official

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1346627338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 CARLSBAD VILLAGE DR",
            "address_2": "SUITE Q",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081957",
            "telephone_number": "760-500-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 CARLSBAD VILLAGE DR",
            "address_2": "SUITE Q",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081957",
            "telephone_number": "760-500-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVE PROFESSIONAL CLINICAL COUNSELORS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-500-3325"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27991",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Susan Watkins, M.A. MFT
• Brittany Sue Watson, DC
• Emily Watson
• Nicolas Stone Watson
• Monika Watts
• Wave Professional Clinical Counselors, Inc.
• Waves of Therapy Marriage and Family Counseling (Waves of Therapy)
• Sheava Okhovat Wax, LMFT
• Jardin Webb, DC
• Olivia Paige Weber

• Marriage & Family Therapist in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.