| Organization Name: | BLUE WATERS COUNSELING |
| NPI Number: | 1104298108 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREA GODFREY (OWNER) |
| Mailing Address: | 6501 Us Highway 431 N Headland |
| State: | AL US |
| Postal Code: | 363455657 |
| Phone Number: | 3347926736 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2015 |
| NPI Last Update Date: | 10/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 3201 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |