Provider Demographics
NPI:1114790359
Name:OCEAN WAVES THERAPY LLC
Entity Type:Organization
Organization Name:OCEAN WAVES THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / LPC
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:302-496-7116
Mailing Address - Street 1:19266 COASTAL HWY UNIT 4
Mailing Address - Street 2:BOX68
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971
Mailing Address - Country:US
Mailing Address - Phone:302-496-7116
Mailing Address - Fax:
Practice Address - Street 1:36407 FIR DR
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-8661
Practice Address - Country:US
Practice Address - Phone:302-496-7116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty