Blue Wave Counseling & Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE WAVE COUNSELING & PSYCHOTHERAPY LLC

Practice address

1519 Market St
Pocomoke City, MD 21851-1711

Phone

(484) 767-5216

NPI assigned

Dec 8, 2020

Last updated

Feb 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sean Butler, LCSW-CNPI 1770039273

Title

Owner

Phone

(484) 767-5216

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, and the practitioner matching its NPPES authorized official.

• Sean Butler

  • Clinical Social Worker
  • Pocomoke City, MD
  • NPI 1770039273
  Authorized official Same address or phone

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1891391587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 MARKET ST",
            "city": "POCOMOKE CITY",
            "state": "MD",
            "postal_code": "218511711",
            "telephone_number": "484-767-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 MARKET ST",
            "city": "POCOMOKE CITY",
            "state": "MD",
            "postal_code": "218511711",
            "telephone_number": "484-767-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WAVE COUNSELING & PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-767-5216",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "666873900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esther Marie Betz, CSC-AD
• Caitlin Bishop
• Stephanie Blevins
• Blossom Therapy, LLC
• Blue Heron Medical Group LLC
• Lauren Bozman, PHARMD
• Carolyn Bridson, PTA
• Sarah Schiffer Butler
• Sean Butler
• Victoria Grace Bynum, LMSW

• Clinical Social Worker in Pocomoke City, MD
• Providers in Pocomoke City, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.