Organization
WAVE COUNSELING LCSW
Active
Other names
Wave Counseling LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
PENINA PHILLIPS (OFFICE MANAGER)
(516) 551-2462
Entity
Organization
Contact information
Practice address
112 W 34TH ST FL 18, NEW YORK, NY 10120-0001
(516) 551-2462
Mailing address
112 W 34TH ST FL 18, NEW YORK, NY 10120-0001
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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