DEEPWATER COUNSELING, PLLC (NPI# 1639600687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639600687 |
| Entity Type | Organization |
| Organization Name | DEEPWATER COUNSELING, PLLC |
| Practice Address |
2048 Washtenaw Rd Lower Level, Suite 3 Ypsilanti MI 48197-1889 |
| Mailing Address |
24545 Merriman Rd New Boston MI 48164-9467 |
| Practice Telephone | 7342030183 |
| Mailing Telephone | 7347768251 |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |
| Authorized Official Name | MRS. JENNIFER BLOUGH (OWNER) |
| Authorized Official Telephone | 7347768251 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401014637 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PERSONAL NPI | 1528456019 | 01 |
| Street Address |
2048 WASHTENAW RD LOWER LEVEL, SUITE 3 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-1889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811051261 | Nancy Alice Burks | Psychologist | 2048 Washtenaw Rd, Suite Ll, Ypsilanti, MI 48197-1889 | 2006-12-20 |
| 1487189031 | Funcare | Exclusive Provider Organization | 2048 Washtenaw Rd, Ypsilanti, MI 48197-1889 | 2017-04-20 |
| 1528506359 | Counseling Center of Southeastern Michigan, Pllc | Counselor | 2048 Washtenaw Rd, Upper Level, North Suite, Ypsilanti, MI 48197-1889 | 2017-01-31 |
| 1912363508 | Naomi Zikmund-fisher, Lmsw, LLC | Social Worker | 2048 Washtenaw Rd, Ypsilanti, MI 48197-1889 | 2016-01-12 |
| 1104294941 | Sylvia Jones | Counselor | 2048 Washtenaw Rd, Upper Level, North Suite, Ypsilanti, MI 48197-1889 | 2015-09-10 |
| 1528456019 | Jennifer Blough | Counselor | 2048 Washtenaw Rd, Lower Level, Ste. 3, Ypsilanti, MI 48197-1889 | 2015-01-06 |
| 1174863823 | Naomi Zikmund-fisher | Social Worker | 2048 Washtenaw Rd, Upper Level, Suite N, Ypsilanti, MI 48197-1889 | 2013-02-18 |
| 1174773584 | Karen Susan Zokas | Social Worker | 2048 Washtenaw Rd, Upper Suite, Ypsilanti, MI 48197-1889 | 2008-09-22 |
| 1972627453 | Anna M. Stapleton | Psychologist | 2048 Washtenaw Rd, Lower Level, Ypsilanti, MI 48197-1889 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780074526 | Erin Pearce Kilpatrick | Counselor | 4842 Lakeridge St Apt 1a, Ypsilanti, MI 48197-1409 | 2015-02-02 |
| 1194124438 | Abbott Daimler | Counselor | 611 Norris St, Ypsilanti, MI 48198-2823 | 2014-08-21 |
| 1427479005 | Eddie Miller Jr. | Counselor | 1341 Levona St, Ypsilanti, MI 48198-6412 | 2013-12-26 |
| 1891124749 | Sandra Denise Simmons | Counselor | 5577 Whittaker Rd, Ypsilanti, MI 48197-9752 | 2013-11-01 |
| 1376970137 | Yolanda Dunsmore | Counselor | 9543 Glenhill Dr, Ypsilanti, MI 48198-2601 | 2013-10-10 |
| 1932543733 | Ebony Theresa Montgomery | Counselor | 555 Towner St., Ypsilanti, MI 48198 | 2013-04-23 |
| 1457682767 | Cara Andrea Talaska | Counselor | 32 N Washington St Ste 3, Ypsilanti, MI 48197 | 2010-01-26 |
| 1639303191 | Brenda Y. Averett | Counselor | 302 North Huron, Ypsilanti, MI 48197 | 2009-05-12 |
| 1801073309 | Suzanne Lynn Kapica | Counselor | 7232 Glacier Pointe Dr, Ypsilanti, MI 48197-6115 | 2008-01-28 |
| 1376741777 | Tabrina La Shawn Rieves | Counselor | 302 N Huron St, Ypsilanti, MI 48197-2947 | 2007-07-06 |
| Find all providers in YPSILANTI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.