Deeper Waters Emdr

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DEEPER WATERS EMDR

Practice address

9 NE Park Ave
Baxley, GA 31513-0003

Phone

(912) 278-4739

NPI assigned

May 19, 2026

Last updated

Jul 27, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela Candace Thornton, LPC

Title

Licensed Professional Counselor

Phone

(912) 937-4708

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1083544563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 PINE ST LOT 10",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315137077",
            "telephone_number": "912-278-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NE PARK AVE",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130003",
            "telephone_number": "912-278-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPER WATERS EMDR",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-19",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "THORNTON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "CANDACE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "912-937-4708",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Baxley, GA
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• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.