Ann Waters, LPC, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ANN WATERS, LPC, LLC

Practice address

3589 Habersham at Northlake
Tucker, GA 30084-4001

Phone

(678) 757-4453

Fax

(678) 530-1034

NPI assigned

Oct 26, 2018

Organization subpart

No

Name

Ann Waters, LPCNPI 1346259264

Title

Owner

Phone

(678) 757-4453

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 26, 2021.

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1306313481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3589 HABERSHAM AT NORTHLAKE",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844001",
            "telephone_number": "678-757-4453",
            "fax_number": "678-530-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3589 HABERSHAM AT NORTHLAKE",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844001",
            "telephone_number": "678-757-4453",
            "fax_number": "678-530-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN WATERS, LPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-757-4453",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003245197A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.