KWR, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003197 Issued in GA

Legal business name

KWR, INC.

Practice address

2450 Atlanta Hwy Ste 1403
Cumming, GA 30040-1277

Phone

(678) 947-9279

Fax

(678) 947-9255

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Ruth Waters-Rose, LPCNPI 1558427906

Title

President

Phone

(678) 947-9279

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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.

• Kimberly R. Waters-Rose, LPC

  • Professional Counselor
  • Cumming, GA
  • NPI 1558427906
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645315200000",
    "number": "1316003619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 408",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300280408",
            "telephone_number": "678-947-9279",
            "fax_number": "678-947-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ATLANTA HWY STE 1403",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401277",
            "telephone_number": "678-947-9279",
            "fax_number": "678-947-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2022-02-20",
        "certification_date": "2022-02-20",
        "status": "A",
        "authorized_official_last_name": "WATERS-ROSE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-947-9279",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "003197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Cumming, GA
• Providers in Cumming, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.