Provider Demographics
NPI:1124501937
Name:WATERFORD COUNSELING LLC
Entity type:Organization
Organization Name:WATERFORD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:
Authorized Official - Last Name:ORME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-618-2476
Mailing Address - Street 1:6545 PRESTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2702
Mailing Address - Country:US
Mailing Address - Phone:214-618-2476
Mailing Address - Fax:214-618-2478
Practice Address - Street 1:6545 PRESTON RD STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2702
Practice Address - Country:US
Practice Address - Phone:214-618-2476
Practice Address - Fax:214-618-2478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty