Provider Demographics
NPI:1265672539
Name:DEEP WATERS COUNSELING SERVICES
Entity Type:Organization
Organization Name:DEEP WATERS COUNSELING SERVICES
Other - Org Name:COMPASSION CONNECTION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-885-1008
Mailing Address - Street 1:540 DELWAR ROAD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236
Mailing Address - Country:US
Mailing Address - Phone:412-885-4796
Mailing Address - Fax:412-885-4769
Practice Address - Street 1:540 DELWAR ROAD
Practice Address - Street 2:SUITE 2B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236
Practice Address - Country:US
Practice Address - Phone:412-885-4796
Practice Address - Fax:412-885-4769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health