Watershed Counseling Associates, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1207 Issued in MS

Legal business name

WATERSHED COUNSELING ASSOCIATES, PLLC

Practice address

1635 Lelia Dr Ste 203
Jackson, MS 39216-4874

Phone

(601) 362-7020

NPI assigned

Oct 14, 2013

Last updated

Oct 14, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell Schulte, MAMFT, LPC, CSASNPI 1336299288

Title

Co Owner, LPC

Phone

(601) 842-4385

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell William Schulte, LPC

  • Professional Counselor
  • Pearl, MS
  • NPI 1336299288
  NPD (past) Authorized official
• Catherine Coffey, MAMFTC, LPC

  • Professional Counselor
  • Jackson, MS
  • NPI 1104159128
  NPD (past)

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1407284235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 LELIA DR STE 203",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164874",
            "telephone_number": "601-362-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 LELIA DR STE 203",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164874",
            "telephone_number": "601-362-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSHED COUNSELING ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "SCHULTE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CO OWNER, LPC",
        "authorized_official_telephone_number": "601-842-4385",
        "authorized_official_credential": "MAMFT, LPC, CSAS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Washington, PHARMD
• SE'Deidrui K Washington
• Henry C Waterer III, M.D.
• Rebecca Rieves Waterer, M.D.
• Kimbell Bingham Waters, LCSW
• Angela Watkins
• Beonka Watkins
• Clyde A Watkins Jr., M.D.
• Ladaryl Lorraine Watkins, NP
• Linda Marie Watkins, N.P.

• Professional Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.