Provider Demographics
NPI:1215529896
Name:STRONGWATER COUNSELING INC.
Entity type:Organization
Organization Name:STRONGWATER COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:207-314-1404
Mailing Address - Street 1:647 US ROUTE 1 UNIT 14-281
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1689
Mailing Address - Country:US
Mailing Address - Phone:207-314-1404
Mailing Address - Fax:
Practice Address - Street 1:647 US ROUTE 1 UNIT 14-281
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1689
Practice Address - Country:US
Practice Address - Phone:207-314-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center