Provider Demographics
NPI:1396213880
Name:CALM WATERS COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:CALM WATERS COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMSW, CAADC
Authorized Official - Phone:773-621-0177
Mailing Address - Street 1:3192 VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4562
Mailing Address - Country:US
Mailing Address - Phone:773-621-0177
Mailing Address - Fax:
Practice Address - Street 1:3301 VETERANS DR STE 106
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4592
Practice Address - Country:US
Practice Address - Phone:773-621-0177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty