Robert K. Waatsa, L.P.C.C., L.A.D.A.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CCMH0208201 Issued in NM

Practice address

20 RT 301 North
Zuni, NM 87327

Phone

(505) 782-5719

Fax

(505) 782-5735

NPI assigned

Jan 24, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Zuni Recovery Center

  • Community/Behavioral Health Agency
  • Zuni, NM
  • NPI 1720406903
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1003154170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "873270339",
            "telephone_number": "505-782-5719",
            "fax_number": "505-782-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 RT 301 NORTH",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "87327",
            "telephone_number": "505-782-5719",
            "fax_number": "505-782-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAATSA",
        "first_name": "ROBERT",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "L.P.C.C., L.A.D.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-24",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0159721",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0156201",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CCMH0208201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Gene Stevenson
• Peter Summerfelt, D.M.D.
• Rachel Leftwich Trippett, MD
• Laura Urbanski, M.D.
• Joy Della McQuery Vala, MD
• John David Walker, DDS
• Valory Elizabeth Wangler, MD
• Camilo Pavel Werlin, MD
• Eve Marina Wiggins, MD
• Maria B. Williams, PH.D.

• Mental Health Counselor in Zuni, NM
• Providers in Zuni, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.