Living Water Christian Counseling Center

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

LIVING WATER CHRISTIAN COUNSELING CENTER

Practice address

258 NB Gratiot Ave
Mount Clemens, MI 48043-5749

Phone

(586) 954-0475

NPI assigned

Oct 11, 2013

Organization subpart

No

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

Authorized official

Name

Mr. John Elbert O'Neal Sr.

Title

Exec.Director/Owner

Phone

(586) 954-0475

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1194152983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 NB GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435749",
            "telephone_number": "586-954-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 NB GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435749",
            "telephone_number": "586-954-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATER CHRISTIAN COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-11",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ELBERT",
        "authorized_official_title_or_position": "EXEC.DIRECTOR/OWNER",
        "authorized_official_telephone_number": "586-954-0475",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer T Lewis, LMSW-C, LCSW, LICSW
• Life Skills Centers, Inc.
• Natesh Lingam, MD
• Tysha Linnex
• Brian Michael Litch, DO
• Cynthia Lockwood
• Joyce Michele Logan
• Timothy David Logan, D.O.
• Kevin Paul Lokar, M.D.
• Gino Michael Lombardo, DO

• Early Intervention Provider Agency in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Early Intervention Provider Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; 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.