MEDICARE: DEEPER WELL 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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1659214153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEEPER WELL COUNSELING LLC

Provider Business Mailing Address
First Line	:	8401 MAYLAND DR # 5642
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 W MAIN ST UNIT B
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4527
Country	:	US
Telephone Number	:	804-293-0498
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CINNAMON LANGLEY
Credential	:	LCSW
Telephone Number	:	573-718-4728

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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