Keyonia Shaneice Waters

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701010462 Issued in VA

Practice address

2100 Washington Blvd FL 4
Arlington, VA 22204-5717

Phone

(703) 228-1700

NPI assigned

Nov 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arlington County Government Department of Managment and FinanceGroup PAC ID 7214928803, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arlington County Government Department of Managment & Finance

  • Community/Behavioral Health Agency
  • Arlington, VA
  • NPI 1043280415

  DC

  Medicare reassignment Care Compare group NPD (past)
• Arlington County Government Department of Managment & Finance

  • Emergency Medical Services (Emergency Medicine) Physician
  • Arlington, VA
  • NPI 1073104832
  NPD (past)

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1316602113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WASHINGTON BLVD FL 4",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WASHINGTON BLVD FL 4",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045717",
            "telephone_number": "703-228-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KEYONIA",
        "middle_name": "SHANEICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701010462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camryn Washington, ED.S, LPC-A
• Joanne Alfreda Washington
• Victor Archibald Washington, PT, DPT
• Geatenet G Wasia
• Jean Waterbury
• Emily K Watts
• Mia Christine Watts, M.D.
• Kay Waud, M.D.
• Alexandra Elizabeth Weatherly, MA
• Daniel Weaver, LMT

• Professional Counselor in Arlington, VA
• Providers in Arlington, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.