Deep Tides Therapy PLLC

Social Worker · Georgetown, TX

Organization Active NPI

NPI number 1649076191

Practice location

1804 E 18TH St
Georgetown, TX 78626-7322
Phone
(503) 754-2817

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NPI record

NPI
1649076191
Entity type
Organization (Type 2)
Enumeration date
February 24, 2025
Last updated
February 24, 2025
Certified
February 24, 2025
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Social Worker Primary 104100000X — —

Mailing address

14205 N Mo Pac Expy Ste 570
Austin, TX 78728-6529

Authorized official

Name
Corina Wolfenstein
Title
Owner of Entity
Phone
(503) 754-2817

About Deep Tides Therapy PLLC

Deep Tides Therapy PLLC is a healthcare organization registered in the NPI registry with the primary taxonomy Social Worker (code 104100000X). The practice location is 1804 E 18TH St, Georgetown, TX 78626-7322. The NPI number 1649076191 was assigned on February 24, 2025 and the record was last updated on February 24, 2025.

The authorized official for this organization is Corina Wolfenstein, Owner of Entity.

Frequently asked questions

What is the NPI number of Deep Tides Therapy PLLC?

The NPI number is 1649076191.

What is the phone number of Deep Tides Therapy PLLC?

The phone number listed for the practice location is (503) 754-2817.

Where is Deep Tides Therapy PLLC located?

1804 E 18TH St, Georgetown, TX 78626-7322.

What is the taxonomy code for Deep Tides Therapy PLLC?

The primary taxonomy code is 104100000X – Social Worker.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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