Indigo Waters Counseling Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29893 Issued in CA

Legal business name

INDIGO WATERS COUNSELING SERVICES

Practice address

13406 Donner Pass Rd
Truckee, CA 96161-3822

Phone

(530) 448-0203

NPI assigned

Oct 16, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Kirsten Brutzman-Livak, L.C.S.W.

Title

Owner

Phone

(530) 448-0203

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1013388966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2874",
            "city": "OLYMPIC VALLEY",
            "state": "CA",
            "postal_code": "961462874",
            "telephone_number": "530-448-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13406 DONNER PASS RD",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961613822",
            "telephone_number": "530-448-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO WATERS COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "BRUTZMAN-LIVAK",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-448-0203",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29893",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "29893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Andrew Hovenic, M.D.
• Alexander Humenetskyj
• Jacqueline Nicole Hurt-Coppola, MFT
• Denice Helena Hynd, REGISTERED DIETITIAN
• Ifoster, Inc.
• Meggie Inouye, ARNP
• J V Foley MD PC
• Aysia Jackson
• Christine Farson Jackson, O.D.
• Megan Jamison, LCSW

• Clinical Social Worker in Truckee, CA
• Providers in Truckee, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.