Healing Waters Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14919 Issued in MD

Legal business name

HEALING WATERS PSYCHOTHERAPY, LLC

Practice address

966 Hungerford Dr Ste 20a
Rockville, MD 20850-1741

Phone

(240) 681-5058

NPI assigned

Jul 6, 2018

Last updated

Oct 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth S Henrich, LCSW-CNPI 1922427194

Title

Owner

Phone

(240) 681-5058

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Henrich, LCSW-C

  • Clinical Social Worker
  • Rockville, MD
  • NPI 1922427194

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Sandra Martins, LCSW-C

  • Clinical Social Worker
  • Bethesda, MD
  • NPI 1700330727

  DC

  Medicare reassignment Care Compare group NPD
• Priscilla Villavicencio, LMSW

  • Mental Health Counselor
  • Rockville, MD
  • NPI 1306634753

  DC

  Medicare reassignment Care Compare group NPD
• Tekshia Innocent

  • Social Worker
  • Rockville, MD
  • NPI 1932829785
  NPD
• Crystal August, LCSW-C

  • Clinical Social Worker
  • Bethesda, MD
  • NPI 1114342672
  NPD (past)

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1083100630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 HUNGERFORD DR STE 20A",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501741",
            "telephone_number": "240-681-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 HUNGERFORD DR STE 20A",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501741",
            "telephone_number": "240-681-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING WATERS PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "HENRICH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-681-5058",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4870243",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4942002",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214235000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600958728",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "CL110001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Rockville, MD
• Providers in Rockville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.