Tyshon Waters, LPC, CPRP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC012109 Issued in GA

Practice address

1811 Saint Ives Xing
Stockbridge, GA 30281-9011

Phone

(678) 670-1816

NPI assigned

Jun 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Greater Dimensions Counseling & Consulting

  • Professional Counselor
  • Stockbridge, GA
  • NPI 1407598691
  NPD Authorized official

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1457927485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 EVANS DR UNIT 456",
            "city": "REX",
            "state": "GA",
            "postal_code": "302732710",
            "telephone_number": "678-670-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 SAINT IVES XING",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819011",
            "telephone_number": "678-670-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "TYSHON",
        "credential": "LPC, CPRP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amoy Ward
• Marjorie J Warren, M.D.
• Jennifer Washington
• Mary Washington, REGISTERED NURSE
• Sybil A Washington
• Andrea Watkins-Davenport
• Elizabeth Watkins, MD
• Terri L Watkins, MSN RN CCM
• Robert Coleman Watson Jr., D.M.D.
• Dorothy D Watts, LCSW

• Professional Counselor in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.