Organization Active NPI

Living Water Counseling LLC

  • Mental Health Counselor
  • Wilmington, DE
National Provider Identifier
1508401258
Registry record updated Nov 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIVING WATER COUNSELING LLC
Practice address
3522 Silverside Rd Ste 32
Wilmington, DE 19810-4915
Phone
(443) 553-7317
NPI assigned
Nov 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2019

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

Authorized official

Name
Mrs. Evelyn Cunliffe De Melker, MA, NCC, LPC
Title
Owner
Phone
(443) 553-7317

Specialties & licenses 1

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

Addresses

Primary practice location

3522 Silverside Rd Ste 32
Wilmington, DE 19810-4915

Mailing address

506 Counterpoint Cir
Havre de Grace, MD 21078-2691
Phone (443) 553-7317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240125000257 DE Part B Supplier - Clinic/Group Practice 5991158008 Receives reassigned benefits from 5 practitioners
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Locations

3522 Silverside Rd
Wilmington, DE 19810
Phone (443) 553-7317

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1573862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573862400000",
    "number": "1508401258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 COUNTERPOINT CIR",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782691",
            "telephone_number": "443-553-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 SILVERSIDE RD STE 32",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104915",
            "telephone_number": "443-553-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATER COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-16",
        "last_updated": "2019-11-16",
        "status": "A",
        "authorized_official_last_name": "DE MELKER",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "CUNLIFFE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-553-7317",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, NCC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.