# DEEP RIVER COUNSELING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578945515
- **Authorized official:** JUDITH L. ANDERSON MA, LPC, ATR (OWNER/MANAGER)
- **Authorized official phone:** (541) 217-0890

## Contact information

- **Practice address:** 375 PARK AVE STE B, COOS BAY, OR 97420-2244
- **Practice address phone:** (541) 217-0890
- **Practice address fax:** (541) 266-8408
- **Mailing address:** PO BOX 1478, COOS BAY, OR 97420-0331
- **Mailing address phone:** (541) 217-0890
- **Mailing address fax:** (541) 266-8408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | C2373 | OR | Yes |

## Other

- **Enumeration date:** 06/26/2015
- **Last updated:** 07/11/2015