Waves of Change Counseling Services, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002045 Issued in CT

Legal business name

WAVES OF CHANGE COUNSELING SERVICES, LLC

Practice address

92 N Summit St Ste 2E
Southington, CT 06489-3000

Phone

(203) 677-0919

NPI assigned

Mar 26, 2018

Organization subpart

No

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

Authorized official

Name

Miss Chrystal Long, LPC

Title

Licensed Professional Counselor

Phone

(203) 677-0919

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1487159117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 N SUMMIT ST STE 2E",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 N SUMMIT ST STE 2E",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893000",
            "telephone_number": "203-677-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVES OF CHANGE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "CHRYSTAL",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "203-677-0919",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Walton, OTR/L
• Aaron Wang
• Lauren Wang
• Yelena Wasser
• Watertown Medical Associates, LLC
• Judith Wayton, LPC
• Weave Your Life LLC
• Christine Welch-Meier, LCSW
• William Henry Welch III, D.D.S.
• Laura White, RN, BSN, IBCLC

• Professional Counselor in Southington, CT
• Providers in Southington, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.