Provider Demographics
NPI:1639906530
Name:GENTLE WATERS, PLLC
Entity type:Organization
Organization Name:GENTLE WATERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEVENEY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-692-0225
Mailing Address - Street 1:95 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-5014
Mailing Address - Country:US
Mailing Address - Phone:540-692-0225
Mailing Address - Fax:
Practice Address - Street 1:133 W SPRINGBROOK RD
Practice Address - Street 2:
Practice Address - City:BROADWAY
Practice Address - State:VA
Practice Address - Zip Code:22815-9527
Practice Address - Country:US
Practice Address - Phone:540-692-0225
Practice Address - Fax:540-896-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty