# WAVE PROFESSIONAL CLINICAL COUNSELORS INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346627338
- **Authorized official:** MARK BREWER (OWNER)
- **Authorized official phone:** (760) 500-3325

## Contact information

- **Practice address:** 1207 CARLSBAD VILLAGE DR, SUITE Q, CARLSBAD, CA 92008-1957
- **Practice address phone:** (760) 500-3325
- **Mailing address:** 1207 CARLSBAD VILLAGE DR, SUITE Q, CARLSBAD, CA 92008-1957
- **Mailing address phone:** (760) 500-3325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 27991 | CA | — |
| 106H00000X | Marriage & Family Therapist | 46057 | CA | Yes |

## Other

- **Enumeration date:** 04/29/2015
- **Last updated:** 06/03/2015