Organization Active NPI

Open Water Wellness PLLC

  • Clinical Social Worker
  • Jacksonville, NC
National Provider Identifier
1437834942
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
OPEN WATER WELLNESS PLLC
Practice address
2 Dewitt St # 10
Jacksonville, NC 28540-5649
Phone
(910) 939-1127
Fax
(855) 978-1077
NPI assigned
Jun 21, 2023
Last updated
May 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
Ms. Karen Kaminski Esala, LCSWNPI 1407409915
Title
Mental Health Clinician/Owner
Phone
(910) 939-1127

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
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2 Dewitt St # 10
Jacksonville, NC 28540-5649

Mailing address

722 Cedar Point Blvd # 186
Cedar Point, NC 28584-8012

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230907000967 NC Part B Supplier - Clinic/Group Practice 0941664114 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, NC

National Provider Directory

National Provider Directory

Locations

2 Dewitt St
#10
Jacksonville, NC 28540
Phone (910) 939-1127

410 New Bridge St
Ste 9B
Jacksonville, NC 28540
Phone (910) 455-4727

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1437834942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 CEDAR POINT BLVD # 186",
            "city": "CEDAR POINT",
            "state": "NC",
            "postal_code": "285848012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DEWITT ST # 10",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405649",
            "telephone_number": "910-939-1127",
            "fax_number": "855-978-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN WATER WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-21",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "KAMINSKI ESALA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MENTAL HEALTH CLINICIAN/OWNER",
        "authorized_official_telephone_number": "910-939-1127",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.