| Deep River Counseling Llc | |
|
375 Park Ave Ste B Coos Bay OR 97420-2244 | |
| (541) 217-0890 | |
| (541) 266-8408 |
| Full Name | Deep River Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 375 Park Ave Ste B, Coos Bay, Oregon |
| Authorized Official Name and Position | Judith L. Anderson (OWNER/MANAGER) |
| Authorized Official Contact | 5412170890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep River Counseling Llc Po Box 1478 Coos Bay OR 97420-0331 Ph: (541) 217-0890 | Deep River Counseling Llc 375 Park Ave Ste B Coos Bay OR 97420-2244 Ph: (541) 217-0890 |
| NPI Number | 1578945515 |
|---|---|
| Provider Enumeration Date | 06/26/2015 |
| Last Update Date | 07/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578945515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | C2373 (Oregon) | Primary |
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