Provider Demographics
NPI:1558235010
Name:OPEN SPACE COUNSELING
Entity type:Organization
Organization Name:OPEN SPACE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHAYNA
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCMCH LCAS LPC
Authorized Official - Phone:802-222-7588
Mailing Address - Street 1:16 WILSON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1512
Mailing Address - Country:US
Mailing Address - Phone:802-222-7588
Mailing Address - Fax:
Practice Address - Street 1:16 WILSON CREEK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1512
Practice Address - Country:US
Practice Address - Phone:802-222-7588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty