Provider Demographics
NPI:1932747888
Name:OPEN WATER COUNSELING AND RECOVERY, LLC
Entity type:Organization
Organization Name:OPEN WATER COUNSELING AND RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:330-539-3200
Mailing Address - Street 1:1716 NORTH RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2907
Mailing Address - Country:US
Mailing Address - Phone:330-539-3200
Mailing Address - Fax:
Practice Address - Street 1:1716 NORTH RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2907
Practice Address - Country:US
Practice Address - Phone:330-539-3200
Practice Address - Fax:330-529-5241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty