Provider Demographics
NPI:1194429480
Name:MAKING WAVES COUNSELING & WELLNESS
Entity type:Organization
Organization Name:MAKING WAVES COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:TOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:910-478-7480
Mailing Address - Street 1:2018 EASTWOOD RD STE 222
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7228
Mailing Address - Country:US
Mailing Address - Phone:910-541-8928
Mailing Address - Fax:
Practice Address - Street 1:2018 EASTWOOD RD STE 222
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7228
Practice Address - Country:US
Practice Address - Phone:910-541-8928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1447873823Medicaid