Waterside Therapy Associates, P.L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002961 Issued in NC

Legal business name

WATERSIDE THERAPY ASSOCIATES, P.L.L.C.

Practice address

110 Baltimore St
Williamston, NC 27892-2462

Phone

(252) 944-6076

Fax

(252) 923-0111

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Rita Carol Boyette, LCSWNPI 1326177494

Title

Co-Owner

Phone

(252) 944-6076

Specialties & licenses 2

Addresses

Other identifiers 6

Locations

Practitioners 1

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

• Rita C. Boyette, LCSW

  • Clinical Social Worker
  • Williamston, NC
  • NPI 1326177494
  NPD (past) Authorized official

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1528091972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BALTIMORE ST",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922462",
            "telephone_number": "252-944-6076",
            "fax_number": "252-923-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BALTIMORE ST",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922462",
            "telephone_number": "252-944-6076",
            "fax_number": "252-923-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSIDE THERAPY ASSOCIATES, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "BOYETTE",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "252-944-6076",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5036",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10894",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003548",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102939",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "24392-2143",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "235086",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14144",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Brooke Wallace
• Formecia Wallace, MS, MA, LCAS-A
• Karen C Ward, CRT, RCP
• Kristin Ward Warren, PA-C
• Kortney Shakia Watford
• Latasha Weeks, PHARM.D.
• Brittany James Wells, PA-C
• Kari P White, CRT, RCP
• Linda Jones Whitley, LPC

• Clinical Social Worker in Williamston, NC
• Providers in Williamston, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.