Water Blue Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WATER BLUE THERAPY

Practice address

3443 146TH St
Toledo, OH 43611-2513

Phone

(419) 217-2122

NPI assigned

Jul 6, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Kellie Renee Cousino, LISA

Title

Ceo

Phone

(419) 217-2122

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1003549270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 146TH ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436112513",
            "telephone_number": "419-217-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 146TH ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436112513",
            "telephone_number": "419-217-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER BLUE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "COUSINO",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-217-2122",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LISA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawnta Sharee Washington, LPN, CDP
• Tim Washington
• Norine Wasielewski
• Wasla Transit LLC
• Kayla Wass
• Elizabeth Ann Waterfield, P.C.C.-SUPV.
• Stephanie Waterford, RN
• Lacarmen Waters
• Reginald Stefan Waters
• Mary Beth Watkeys

• Clinical Social Worker in Toledo, OH
• Providers in Toledo, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.