Provider Demographics
NPI:1609468172
Name:CALM BLUE WATERS COUNSELING, PLLC
Entity Type:Organization
Organization Name:CALM BLUE WATERS COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEATH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CASTONGIA
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, BC-TMH, LCMHC,
Authorized Official - Phone:980-689-1794
Mailing Address - Street 1:13420 REESE BLVD W
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7925
Mailing Address - Country:US
Mailing Address - Phone:980-689-1794
Mailing Address - Fax:704-464-4782
Practice Address - Street 1:13420 REESE BLVD W
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7925
Practice Address - Country:US
Practice Address - Phone:980-689-1794
Practice Address - Fax:704-464-4782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)