Active NPI
Timothy David Waters, ACMHC
- Mental Health Counselor
- American Fork, UT
National Provider Identifier
1437696994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 5291774-6009
- Practice address
- 66 S 360 E
American Fork, UT 84003-2590 - Phone
- (801) 449-0017
- NPI assigned
- Jan 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5291774-6009 | UT | Primary |
Addresses
Primary practice location
66 S 360 E
American Fork, UT 84003-2590
Mailing address
11908 S Powder CV
Herriman, UT 84096-7738
Phone (801) 792-9236
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5291774-6009 | UT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485129600000",
"number": "1437696994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11908 S POWDER CV",
"city": "HERRIMAN",
"state": "UT",
"postal_code": "840967738",
"telephone_number": "801-792-9236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 S 360 E",
"city": "AMERICAN FORK",
"state": "UT",
"postal_code": "840032590",
"telephone_number": "801-449-0017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "TIMOTHY",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "ACMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-23",
"last_updated": "2017-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "5291774-6009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in American Fork, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.