Organization
BLUE WAVE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE K JORDAN LMHC (OWNER)
(321) 313-1745
Entity
Organization
Contact information
Practice address
330 N BABCOCK ST, SUITE 102, MELBOURNE, FL 32935-7324
(321) 313-1745
(321) 428-3358
Mailing address
330 N BABCOCK ST, SUITE 102, MELBOURNE, FL 32935-7324
(321) 313-1745
(321) 428-3358
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH-9263
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001041900
—
FL
Enumeration date
01/11/2016
Last updated
01/11/2016
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