Provider Demographics
NPI:1932078292
Name:THE THIRD WAVE CENTER FOR MINDFULNESS AND BEHAVIOR THERAPY
Entity type:Organization
Organization Name:THE THIRD WAVE CENTER FOR MINDFULNESS AND BEHAVIOR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONICH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA-TX
Authorized Official - Phone:512-586-9857
Mailing Address - Street 1:1806 W STASSNEY LN STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3645
Mailing Address - Country:US
Mailing Address - Phone:512-586-9857
Mailing Address - Fax:
Practice Address - Street 1:1806 W STASSNEY LN STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3645
Practice Address - Country:US
Practice Address - Phone:512-586-9857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty