Water'S Edge Psychotherapy and Wellness Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WATER'S EDGE PSYCHOTHERAPY AND WELLNESS CENTER

Practice address

47 Maple St
Burlington, VT 05401-4861

Phone

(802) 651-7807

NPI assigned

Dec 17, 2013

Organization subpart

No

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

Authorized official

Name

Linda Wackerman, MSWNPI 1770596447

Title

Partner

Phone

(206) 963-4907

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Linda Wackerman, MSW

  • Clinical Social Worker
  • Seattle, WA
  • NPI 1770596447

  VT

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1285055376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MAPLE ST STE 331",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015097",
            "telephone_number": "206-963-4907",
            "fax_number": "802-861-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MAPLE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014861",
            "telephone_number": "802-651-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER'S EDGE PSYCHOTHERAPY AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "WACKERMAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "206-963-4907",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006773",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018888",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285055376",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arthur Mark Warwick, MD
• Mark James Washenberger
• Emily Anne Wasserman, DNP, APRN, AGNP-C
• Richard Wasserman, M.D.
• Syeda Faryal Wasti
• Gerald Scott Waterman, M.D.
• Patricia Waterman, LCSW
• Austin Waters-Dukes, LICSW
• Brenda Lorraine Waters, M.D., B.S.
• Matthew Wells Watkins, MD

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.