| Deep River Counseling Llc | |
|
1611 County Road B W Ste 201 Roseville MN 55113-4107 | |
| (651) 243-0077 | |
| (651) 273-2201 |
| Full Name | Deep River Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1611 County Road B W, Roseville, Minnesota |
| Authorized Official Name and Position | Joseph Morcomb (OWNER) |
| Authorized Official Contact | 6512430077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep River Counseling Llc 1611 County Road B W Ste 201 Roseville MN 55113-4107 Ph: (651) 243-0077 | Deep River Counseling Llc 1611 County Road B W Ste 201 Roseville MN 55113-4107 Ph: (651) 243-0077 |
| NPI Number | 1659147429 |
|---|---|
| Provider Enumeration Date | 12/01/2023 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Medicare PECOS PAC ID | 8123469632 |
|---|---|
| Medicare Enrollment ID | O20240515002525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659147429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Joseph Patrick Morcomb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154085900 PECOS PAC ID: 5496196909 Enrollment ID: I20240515002726 |
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