| Deep Rivers Family Counseling Inc | |
|
518 28 Rd A207 Grand Junction CO 81501-6556 | |
| (970) 245-3212 | |
| (970) 245-3216 |
| Full Name | Deep Rivers Family Counseling Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 518 28 Rd, Grand Junction, Colorado |
| Authorized Official Name and Position | Matthew J Pettit (FOUNDER/DIRECTOR) |
| Authorized Official Contact | 9706234281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep Rivers Family Counseling Inc 518 28 Rd A207 Grand Junction CO 81501-6556 Ph: (970) 245-3212 | Deep Rivers Family Counseling Inc 518 28 Rd A207 Grand Junction CO 81501-6556 Ph: (970) 245-3212 |
| NPI Number | 1912261603 |
|---|---|
| Provider Enumeration Date | 06/27/2012 |
| Last Update Date | 07/14/2015 |
| Medicare PECOS PAC ID | 5597207936 |
|---|---|
| Medicare Enrollment ID | O20240612004310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912261603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 980 (Colorado) | Primary |
| Provider Name | Matthew Jarvis Pettit |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871745117 PECOS PAC ID: 6406398841 Enrollment ID: I20240614002453 |
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