Organization Active NPI

Deep Waters Counseling, LLC

  • Mental Health Counselor
  • Athens, GA
National Provider Identifier
1548083751
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DEEP WATERS COUNSELING, LLC
Practice address
598 S Milledge Ave Ste 5
Athens, GA 30605-1262
Phone
(770) 676-1868
NPI assigned
Nov 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Aubrey Gold, LPC, NCCNPI 1588486161
Title
President
Phone
(770) 676-1868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

598 S Milledge Ave Ste 5
Athens, GA 30605-1262

Mailing address

752 Fitzroy Dr
Athens, GA 30606-0790
Phone (770) 870-7655

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1548083751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 FITZROY DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306060790",
            "telephone_number": "770-870-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 S MILLEDGE AVE STE 5",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306051262",
            "telephone_number": "770-676-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP WATERS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "AUBREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-676-1868",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.