NPIMap

Organization Active NPI

Bluewaters Counseling and Coaching

  • Mental Health Counselor
  • Dothan, AL
National Provider Identifier
1457825374
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BLUEWATERS COUNSELING AND COACHING
Practice address
256 Honeysuckle Rd Ste 2
Dothan, AL 36305-1168
Phone
(334) 792-6736
NPI assigned
Jan 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Authorized official

Name
Andrea Godfrey, LPC
Title
Owner
Phone
(334) 792-6736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

256 Honeysuckle Rd Ste 2
Dothan, AL 36305-1168

Mailing address

256 Honeysuckle Rd Ste 2
Dothan, AL 36305-1168
Phone (334) 792-6736

Other identifiers 1

IdentifierTypeStateIssuer
511-99810OtherALBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1457825374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 HONEYSUCKLE RD STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051168",
            "telephone_number": "334-792-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 HONEYSUCKLE RD STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051168",
            "telephone_number": "334-792-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEWATERS COUNSELING AND COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-792-6736",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "511-99810",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.