| Restoring Waters Counseling Llc | |
|
2932 1st Ave Hibbing MN 55746-2564 | |
| (218) 297-7679 | |
| (218) 894-6904 |
| Full Name | Restoring Waters Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2932 1st Ave, Hibbing, Minnesota |
| Authorized Official Name and Position | Charlene Colwell (OWNER/MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 2182977679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoring Waters Counseling Llc 2932 1st Ave Hibbing MN 55746-2564 Ph: (218) 297-7679 | Restoring Waters Counseling Llc 2932 1st Ave Hibbing MN 55746-2564 Ph: (218) 297-7679 |
| NPI Number | 1750046249 |
|---|---|
| Provider Enumeration Date | 11/01/2021 |
| Last Update Date | 03/16/2024 |
| Certification Date | 03/16/2024 |
| Medicare PECOS PAC ID | 8022400936 |
|---|---|
| Medicare Enrollment ID | O20220126000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750046249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Charlene M Colwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841629250 PECOS PAC ID: 2365768819 Enrollment ID: I20150228000101 |
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