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Organization

DEEP LAKE COUNSELING SERVICES LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN THOMAS WILTON LPCC, LADC (CHIEF EXECUTIVE OFFICER)
(763) 233-2870
Entity
Organization

Contact information

Practice address
15611 YAKIMA ST NW, RAMSEY, MN 55303-4262
(763) 233-2870
Mailing address
15611 YAKIMA ST NW, RAMSEY, MN 55303-4262
(763) 233-2870

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
04/08/2026
Last updated
04/08/2026
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