Andrew Emory Waters, LPCC, LMHC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH18040 Issued in FL

Practice address

2200 1St Ave S
Minneapolis, MN 55404-3401

Phone

(612) 767-0307

NPI assigned

Aug 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1396355038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6375 NW 77TH PL",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330672405",
            "telephone_number": "845-729-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 1ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043401",
            "telephone_number": "612-767-0307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6375 NW 77th Pl",
            "address_purpose": "LOCATION",
            "city": "Parkland",
            "state": "FL",
            "postal_code": "330672405",
            "country_code": "US",
            "telephone_number": "845-729-9157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ANDREW",
        "middle_name": "EMORY",
        "credential": "LPCC, LMHC, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-07",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304111",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02151",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Procentive",
            "affiliation": "Y",
            "endpointDescription": "EMR",
            "affiliationName": "NUWAY Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2200 1st Ave S",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554043401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Procentive",
            "affiliation": "Y",
            "endpointDescription": "EMR",
            "affiliationName": "NUWAY Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2200 1st Ave S",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554043401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Procentive",
            "affiliation": "Y",
            "endpointDescription": "EMR",
            "affiliationName": "NUWAY Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2200 1st Ave S",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554043401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://andrew-waters.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Simple Practice",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6375 NW 77th Pl",
            "city": "Parkland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330672405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.