Watershed Counseling Center LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

WATERSHED COUNSELING CENTER LLC

Practice address

14855 Liberty St
Montgomery, TX 77356-4631

Phone

(936) 297-5252

NPI assigned

Jul 24, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Larisa Jeannine Loera

Title

President / Owner

Phone

(936) 297-5252

Specialties & licenses 6

Addresses

Locations

Practitioners 3

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

• Stephanie White

  • Counselor
  • Montgomery, TX
  • NPI 1801608419
  NPD
• Barbara Lynn Gagliano, LPC

  • Professional Counselor
  • Montgomery, TX
  • NPI 1629990270
  NPD (past)
• Hannah McKinnies, LMFT

  • Marriage & Family Therapist
  • Montgomery, TX
  • NPI 1104531052
  NPD (past)

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1285314211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14855 LIBERTY ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773564631",
            "telephone_number": "936-297-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14855 LIBERTY ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773564631",
            "telephone_number": "936-297-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSHED COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "LOERA",
        "authorized_official_first_name": "LARISA",
        "authorized_official_middle_name": "JEANNINE",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "936-297-5252",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Montgomery, TX
• Providers in Montgomery, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.

Verify at the official NPI Registry.