Ann Claudette Waters, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC005573 Issued in GA

Practice address

3589 Habersham at Northlake
Tucker, GA 30084

Phone

(678) 757-4453

Fax

(678) 530-1034

NPI assigned

Aug 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ann Bowen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ann Waters, LPC, LLC

  • Professional Counselor
  • Tucker, GA
  • NPI 1306313481

  Professional

  NPD Authorized official
• Peachtree Pediatric Psychology, LLC

  • Intellectual & Developmental Disabilities Psychologist
  • Atlanta, GA
  • NPI 1861998585
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1346259264",
    "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": "30084",
            "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": "30084",
            "telephone_number": "678-757-4453",
            "fax_number": "678-530-1034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Hammond Dr",
            "address_2": "Building 10, Suite 100",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303285532",
            "country_code": "US",
            "telephone_number": "678-999-3477",
            "fax_number": "678-999-3567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ANN",
        "middle_name": "CLAUDETTE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC005573",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "APC001330",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003245197A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "BOWEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Tucker, GA
• Professional Counselor in Georgia

• 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.