NPIMap

Organization Active NPI

Deepwater Counseling, PLLC

  • Professional Counselor
  • Ypsilanti, MI
National Provider Identifier
1639600687
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401014637 Issued in MI
Legal business name
DEEPWATER COUNSELING, PLLC
Practice address
3150 Packard Rd
Ypsilanti, MI 48197-1994
Phone
(734) 203-0183
NPI assigned
Mar 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Authorized official

Name
Mrs. Jennifer Blough, LPCNPI 1528456019
Title
Owner
Phone
(734) 776-8251

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 6401014637 MI Primary

Addresses

Primary practice location

3150 Packard Rd
Ypsilanti, MI 48197-1994

Mailing address

10672 Northwood Hwy
Onekama, MI 49675-9612
Phone (734) 776-8251

Other identifiers 1

IdentifierTypeStateIssuer
1528456019OtherMIPERSONAL NPI

National Provider Directory

National Provider Directory

Locations

3300 Washtenaw Ave
Ste 222
Ann Arbor, MI 48104
Phone (734) 203-0183

2048 Washtenaw Rd
Lowr
Ypsilanti, MI 48197
Phone (734) 751-3522

Practitioners & affiliated clinicians

Practitioners 9

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": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1639600687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10672 NORTHWOOD HWY",
            "city": "ONEKAMA",
            "state": "MI",
            "postal_code": "496759612",
            "telephone_number": "734-776-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 PACKARD RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971994",
            "telephone_number": "734-203-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPWATER COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "BLOUGH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-776-8251",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1528456019",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.