Active NPI
Scott J Waters, LPC
- Professional Counselor
- Eugene, OR
National Provider Identifier
1235501388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C4911
- Practice address
- 1600 Valley River Dr Ste 103
Eugene, OR 97401-2141 - Phone
- (503) 956-3719
- NPI assigned
- Oct 28, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C4911 | OR | Primary |
| Mental Health Counselor | 101YM0800X | MHCA.MC.60501032 | WA |
Addresses
Primary practice location
1600 Valley River Dr Ste 103
Eugene, OR 97401-2141
Mailing address
465 72ND St
Springfield, OR 97478-7237
Phone (503) 956-3719
Other practice location 1
380 Q St Ste 250
Springfield, OR 97477-2147
Phone (503) 956-3719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 12, 2026 through Mar 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHCA.MC.60501032 | WA | MD | Mental Health Counselor |
| C4911 | OR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley River Counseling LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Springfield, OR
- NPI 1821751538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574035200000",
"number": "1235501388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 72ND ST",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974787237",
"telephone_number": "503-956-3719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 VALLEY RIVER DR STE 103",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012141",
"telephone_number": "503-956-3719"
}
],
"practiceLocations": [
{
"address_1": "380 Q St Ste 250",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "OR",
"postal_code": "974772147",
"country_code": "US",
"telephone_number": "503-956-3719",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATERS",
"first_name": "SCOTT",
"middle_name": "J",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-28",
"last_updated": "2019-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C4911",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MHCA.MC.60501032",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.