Provider Demographics
NPI:1356187751
Name:DEEP FLIGHT COUNSELING PLLC
Entity type:Organization
Organization Name:DEEP FLIGHT COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:VEST
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCA
Authorized Official - Phone:828-222-3702
Mailing Address - Street 1:61 LAUREL COVE RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8214
Mailing Address - Country:US
Mailing Address - Phone:828-280-5741
Mailing Address - Fax:
Practice Address - Street 1:390 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1222
Practice Address - Country:US
Practice Address - Phone:828-222-3702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health