Provider Demographics
NPI:1861268401
Name:SWIFT RUNNING WATERS COUNSELING
Entity type:Organization
Organization Name:SWIFT RUNNING WATERS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WESSELS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-813-0975
Mailing Address - Street 1:154 WINDHAM RD
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-3525
Mailing Address - Country:US
Mailing Address - Phone:860-383-9705
Mailing Address - Fax:
Practice Address - Street 1:322 MAIN ST # 2E1H
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-3172
Practice Address - Country:US
Practice Address - Phone:919-813-0975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health