| Waves Of Life Psychotherapy Llc | |
|
1044 Lacey Rd Ste 7 Forked River NJ 08731-1051 | |
| (732) 814-3081 | |
| Not Available |
| Full Name | Waves Of Life Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1044 Lacey Rd Ste 7, Forked River, New Jersey |
| Authorized Official Name and Position | Cathleen Lawrence (OWNER) |
| Authorized Official Contact | 7328143081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waves Of Life Psychotherapy Llc 1012 Laurel Blvd Lanoka Harbor NJ 08734-2721 Ph: (732) 814-3081 | Waves Of Life Psychotherapy Llc 1044 Lacey Rd Ste 7 Forked River NJ 08731-1051 Ph: (732) 814-3081 |
| NPI Number | 1821667767 |
|---|---|
| Provider Enumeration Date | 06/24/2021 |
| Last Update Date | 09/16/2021 |
| Certification Date | 09/16/2021 |
| Medicare PECOS PAC ID | 7810399623 |
|---|---|
| Medicare Enrollment ID | O20210715001388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821667767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cathleen R Lawrence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992094163 PECOS PAC ID: 5092993931 Enrollment ID: I20110624000277 |
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