Living Waters Counseling

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801059772 Issued in MI

Legal business name

LIVING WATERS COUNSELING

Practice address

5955 W Main St
Kalamazoo, MI 49009-8700

Phone

(269) 348-0956

Fax

(269) 353-3132

NPI assigned

Nov 22, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Victor Manzon, LMSW

Title

Owner

Phone

(269) 348-0956

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425600000000",
    "number": "1285901058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2588",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490812588",
            "telephone_number": "269-492-3801",
            "fax_number": "269-373-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098700",
            "telephone_number": "269-348-0956",
            "fax_number": "269-353-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2015-03-06",
        "status": "A",
        "authorized_official_last_name": "MANZON",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-348-0956",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301009199",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801059772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.