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Organization
THIRD WAVE PSYCHOTHERAPY, PLLC
Active
Organization
THIRD WAVE PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN LANDAAS LCSW (OWNER)
(919) 923-8752
Entity
Organization
Contact information
Practice address
5401 SIX FORKS RD STE 200, RALEIGH, NC 27609-4462
(919) 886-4052
Mailing address
5401 SIX FORKS RD STE 200, RALEIGH, NC 27609-4462
(919) 886-4052
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C007721
NC
Other
Enumeration date
07/02/2015
Last updated
01/04/2022
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