Ride the Wave Wellness, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.0004778 Issued in IL

Legal business name

RIDE THE WAVE WELLNESS, INC.

Practice address

123 W Washington St Ste 340
Oswego, IL 60543-8292

Phone

(630) 383-7006

Fax

(630) 383-7006

NPI assigned

Jul 8, 2017

Organization subpart

No

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

Authorized official

Name

Nicole K Knepper, LCPCNPI 1194092635

Title

Owner/Clinical Psychotherapist

Phone

(630) 383-7006

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Nicole Kristine Knepper, LCPC

  • Professional Counselor
  • Oswego, IL
  • NPI 1194092635
  NPD Authorized official

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

{
    "created_epoch": "1499472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499472000000",
    "number": "1356863617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 TWIN FOUNTAIN CT",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605866397",
            "telephone_number": "773-655-1198",
            "fax_number": "630-383-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W WASHINGTON ST STE 340",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438292",
            "telephone_number": "630-383-7006",
            "fax_number": "630-383-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDE THE WAVE WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-08",
        "last_updated": "2017-07-08",
        "status": "A",
        "authorized_official_last_name": "KNEPPER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "630-383-7006",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.0004778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1194092635",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renewed Heart and Mind Therapy, PLLC
• Resilient Growth Therapy PLLC
• Resilient Minds Therapy-PLLC
• Kristen Rexha
• Yarely Ruby Reyes
• Hannah E Rieker, FNP-BC
• Karen L Rittgarn, PT
• Farhat Rizwan
• Robert F. Otto D.M.D., P.C.
• Kelli Robinson, PT

• Mental Health Counselor in Oswego, IL
• Providers in Oswego, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2017; 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.