Blue Wave Counseling

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH-9263 Issued in FL

Legal business name

BLUE WAVE COUNSELING

Practice address

330 N Babcock St
Suite 102
Melbourne, FL 32935-7324

Phone

(321) 313-1745

Fax

(321) 428-3358

NPI assigned

Jan 11, 2016

Organization subpart

No

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

Authorized official

Name

Julie K Jordan, LMHCNPI 1275716888

Title

Owner

Phone

(321) 313-1745

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.

• Julie K Jordan, LMHC

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1275716888
  NPD (past) Authorized official

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1801252515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N BABCOCK ST",
            "address_2": "SUITE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357324",
            "telephone_number": "321-313-1745",
            "fax_number": "321-428-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BABCOCK ST",
            "address_2": "SUITE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357324",
            "telephone_number": "321-313-1745",
            "fax_number": "321-428-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WAVE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-313-1745",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH-9263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001041900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica B Block
• Regan Blomquist
• Bloom Family Medicine, PLLC
• Rosemarie Walsh Bloom, MASSAGE THERAPIST
• Blossom Medspa & Wellness Clinic, LLC
• Cora Marie Blum
• Ashley Blye
• Douglas Boag, ARNP
• Vonda Bobart, MD
• John Daniel Bocinsky, MD

• Mental Health Counselor in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.