| Northern Waters Counseling Group | |
|
112 Arbor Ln Alpena MI 49707-1302 | |
| (989) 340-2131 | |
| Not Available |
| Full Name | Northern Waters Counseling Group |
|---|---|
| Speciality | Counselor |
| Location | 112 Arbor Ln, Alpena, Michigan |
| Authorized Official Name and Position | Dawn Elizabeth Waters (OWNER/CLINICIAN) |
| Authorized Official Contact | 9893402131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Waters Counseling Group 112 Arbor Ln Alpena MI 49707-1302 Ph: (989) 340-2131 | Northern Waters Counseling Group 112 Arbor Ln Alpena MI 49707-1302 Ph: (989) 340-2131 |
| NPI Number | 1689113227 |
|---|---|
| Provider Enumeration Date | 02/15/2017 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Medicare PECOS PAC ID | 6002265261 |
|---|---|
| Medicare Enrollment ID | O20231213001140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689113227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 6401015574 (Michigan) | Primary |
| Provider Name | Dawn Elizabeth Waters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417492125 PECOS PAC ID: 6204285471 Enrollment ID: I20231213001610 |
| Provider Name | Mark O Waters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740636745 PECOS PAC ID: 7012366289 Enrollment ID: I20231213001735 |
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