Watershed Wellness, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WATERSHED WELLNESS, LLC

Practice address

120 E Lake St Ste 205
Sandpoint, ID 83864-1366

Phone

(208) 304-1102

NPI assigned

Jul 18, 2023

Organization subpart

No

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

Authorized official

Name

Mr. David Barth, LCPCNPI 1558784108

Title

Owner

Phone

(208) 304-1102

Specialties & licenses 1

Addresses

Other names 1

• WATERSHED WELLNESS, LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Barth, LCPC

  • Mental Health Counselor
  • Coeur D Alene, ID
  • NPI 1558784108
  NPD Authorized official

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1487334264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 S LAVINA AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641144",
            "telephone_number": "208-304-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E LAKE ST STE 205",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641366",
            "telephone_number": "208-304-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSHED WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "BARTH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-304-1102",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATERSHED WELLNESS, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Russell Wanek, RPH
• Joseph Wassif
• Gloria Jennings Waterhouse, PHD
• Jeremy J Waters, M.D.
• Kara R Waters, D.O
• James Harvey Watts III, M.D.
• Megan Rita Waugaman, PMHNP
• Nichole Webber
• Mark Edward Weber, M.D.
• Ronald Blaze Welch, D.C.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.