Active NPI
Bethany J Watters-Miller
- Mental Health Counselor
- Bowler, WI
National Provider Identifier
1023700481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7479-226
- Practice address
- W12802 County Road a
Bowler, WI 54416-9551 - Phone
- (175) 793-4000
- NPI assigned
- May 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 19780-130 | WI | |
| Mental Health Counselor | 101YM0800X | 7479-226 | WI | Primary |
Addresses
Primary practice location
W12802 County Road a
Bowler, WI 54416-9551
Mailing address
PO Box 86
Bowler, WI 54416-0086
Phone (715) 793-0531
Other names 1
- Bethany J Watters
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19780-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 7479-226 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1023700481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86",
"city": "BOWLER",
"state": "WI",
"postal_code": "544160086",
"telephone_number": "715-793-0531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W12802 COUNTY ROAD A",
"city": "BOWLER",
"state": "WI",
"postal_code": "544169551",
"telephone_number": "175-793-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTERS-MILLER",
"first_name": "BETHANY",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-24",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "19780-130",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "7479-226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BETHANY",
"last_name": "WATTERS",
"middle_name": "J",
"credential": "SAC-IT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bowler, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.