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Organization
WAVES OF CHANGE COUNSELING GROUP LLC
Active
Organization
WAVES OF CHANGE COUNSELING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY J OTT LADC-1, LCSW (OWNER)
(781) 816-8281
Entity
Organization
Contact information
Practice address
475 HILLSIDE AVE STE 2, NEEDHAM, MA 02494-1200
(781) 816-8218
Mailing address
475 HILLSIDE AVE STE 2, NEEDHAM, MA 02494-1200
(781) 816-8218
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18460
COMMERICAL HEALTH INSURANCE
MA
Enumeration date
06/14/2021
Last updated
06/14/2021
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