Provider Demographics
NPI:1689145302
Name:DEER PARK COUNSELING LLC
Entity Type:Organization
Organization Name:DEER PARK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CMHS, CDP
Authorized Official - Phone:509-599-1535
Mailing Address - Street 1:1705 E GREENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-8213
Mailing Address - Country:US
Mailing Address - Phone:509-599-1535
Mailing Address - Fax:
Practice Address - Street 1:23 E CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006-5002
Practice Address - Country:US
Practice Address - Phone:509-599-1535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty