Provider Demographics
NPI:1699542191
Name:RECOVERY WATERS COUNSELING LLC
Entity type:Organization
Organization Name:RECOVERY WATERS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MA
Authorized Official - Phone:907-406-7640
Mailing Address - Street 1:9061 E FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9317
Mailing Address - Country:US
Mailing Address - Phone:907-406-7640
Mailing Address - Fax:877-354-5075
Practice Address - Street 1:9061 E FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9317
Practice Address - Country:US
Practice Address - Phone:907-406-7640
Practice Address - Fax:877-354-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty