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NPI Code Detail

MEDICARE: DEEP RIVER COUNSELING LLC

MEDICARE: DEEP RIVER COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1659147429
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEEP RIVER COUNSELING LLC
Provider Business Mailing Address
First Line : 1611 COUNTY ROAD B W
Second Line : STE 312
City : ROSEVILLE
State : MN
Zip : 55113-4107
Country : US
Telephone Number : 651-243-0077
Fax Number : 651-273-2201
Provider Business Practice Location Address
First Line : 1611 COUNTY ROAD B W
Second Line : STE 312
City : ROSEVILLE
State : MN
Zip : 55113-4107
Country : US
Telephone Number : 651-243-0077
Fax Number : 651-273-2201
Authorized Official
Title or Position : OWNER
Name : MR. JOSEPH MORCOMB
Credential : LPCC
Telephone Number : 651-243-0077
Provider Enumeration Date : 12/01/2023
Last Update Date : 09/16/2025

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Directions to “DEEP RIVER COUNSELING LLC ” Practice Location

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