Anita Toyo Waterman, LICSWA
Individual provider Active NPI Clinical Social Worker · Cusick, WA
NPI 1487212239 · NPPES record last updated May 6, 2024
Key facts
- NPI
- 1487212239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SC61473466 (WA)
- Practice address
- 1821 N. Leclerc Rd
Cusick, WA 99119 - Phone
- (509) 447-7111
- NPI assigned
- Jun 5, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240610003189 | WA | Practitioner - Clinical Social Worker | 3274075981 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalispel Indian Community of the Kalispel Reservation Washington | Current |
Accepting new patients | |
| Kalispel Indian Community of the Kalispel Reservation Washington | Current | Accepting new patients | |
| Kalispel Tribe-Camas Institute | Current |
Accepting new patients | |
| Pend Oreille County Counseling Services | Mental Health | Past | Accepting new patients |
| Pend Oreille County Counseling Services | Mental Health | Past | Accepting new patients |
Locations
934 S Garfield Rd
Airway Heights, WA 99001
Phone (509) 789-7630
1821 Leclerc Rd N
Cusick, WA 99119
Phone (509) 447-7111
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/pendoreilleco/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SC61473466 | WA | Yes |
Addresses
Primary practice location
1821 N. Leclerc Rd
Cusick, WA 99119
Mailing address
PO Box 5055
Newport, WA 99156-5055
Other providers in Cusick, WA
- Rosanna Grace Robison
- April R Sattleen
- Dillon Raymond Seeber
- Jennifer Marie Tackitt
- James Douglas Volk
- Samantha Joann Wynn
All providers in Cusick, WA · Clinical Social Worker in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.