Provider Demographics
NPI:1184507311
Name:RESTORING WAVES
Entity type:Organization
Organization Name:RESTORING WAVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, LCSWA
Authorized Official - Prefix:MS
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSWA
Authorized Official - Phone:919-602-8829
Mailing Address - Street 1:2325 NC HIGHWAY 96 S
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-8562
Mailing Address - Country:US
Mailing Address - Phone:919-602-8829
Mailing Address - Fax:
Practice Address - Street 1:2325 NC HIGHWAY 96 S
Practice Address - Street 2:
Practice Address - City:FOUR OAKS
Practice Address - State:NC
Practice Address - Zip Code:27524-8562
Practice Address - Country:US
Practice Address - Phone:919-602-8829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty