| Deeper Well Psychotherapy And Counseling, Llc | |
|
120 Sw 4th St Corvallis OR 97333-4724 | |
| (541) 262-0080 | |
| Not Available |
| Full Name | Deeper Well Psychotherapy And Counseling, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 120 Sw 4th St, Corvallis, Oregon |
| Authorized Official Name and Position | Maria P Orr (OWNER) |
| Authorized Official Contact | 8313315993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deeper Well Psychotherapy And Counseling, Llc 3316 Se Hathaway Dr Corvallis OR 97333-9262 Ph: (831) 331-5993 | Deeper Well Psychotherapy And Counseling, Llc 120 Sw 4th St Corvallis OR 97333-4724 Ph: (541) 262-0080 |
| NPI Number | 1548748361 |
|---|---|
| Provider Enumeration Date | 08/02/2018 |
| Last Update Date | 04/10/2023 |
| Certification Date | 04/10/2023 |
| Medicare PECOS PAC ID | 4880131580 |
|---|---|
| Medicare Enrollment ID | O20240730004241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548748361 | NPI | - | NPPES |
| 1497192306 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Maria P Orr |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497192306 PECOS PAC ID: 6608313309 Enrollment ID: I20240809003080 |
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