Living Waters Counseling LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LIVING WATERS COUNSELING LLC

Practice address

5296 S Commerce Dr Ste 206
Murray, UT 84107-5355

Phone

(801) 599-0649

NPI assigned

Oct 11, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Ronnie James Llewelyn, PSY.D.NPI 1801838602

Title

Owner/Psychologist

Phone

(801) 599-0649

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronnie James Llewelyn, PSY.D.

  • Clinical Psychologist
  • Salt Lake City, UT
  • NPI 1801838602
  Medicare reassignment NPD Authorized official
• Daxton Mark Johnson

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1720775448
  Medicare reassignment NPD

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1295497873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7016 W SAW TIMBER WAY",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840811907",
            "telephone_number": "801-599-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5296 S COMMERCE DR STE 206",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075355",
            "telephone_number": "801-599-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "LLEWELYN",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "801-599-0649",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Murray, UT
• Providers in Murray, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.