New Waves Wellness Center, Inc.

Primary specialty

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

License

LCSW3180 Issued in HI

Legal business name

NEW WAVES WELLNESS CENTER, INC.

Practice address

3660 Baldwin Ave
Makawao, HI 96768-7503

Phone

(808) 205-8055

NPI assigned

Sep 30, 2011

Organization subpart

No

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

Authorized official

Name

Teri Holter, LCSWNPI 1801018510

Title

Treasurer

Phone

(808) 205-8055

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Practitioners 2

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

• Teri L Holter, LCSW, DCSW

  • Clinical Social Worker
  • Makawao, HI
  • NPI 1801018510
  Medicare reassignment Authorized official
• Bettina Wong Haerer, M.D.

  • Psychiatry Physician
  • Wailuku, HI
  • NPI 1124193578
  NPD (past)

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1598049140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967680458",
            "telephone_number": "808-205-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 BALDWIN AVE",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967687503",
            "telephone_number": "808-205-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW WAVES WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "HOLTER",
        "authorized_official_first_name": "TERI",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "808-205-8055",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "HI",
            "license": "LCSW3180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Makawao, HI
• Providers in Makawao, HI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.