Amanda Waters, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61136957 Issued in WA

Practice address

1616 Cornwall Ave Ste 205
Bellingham, WA 98225-4642

Phone

(360) 676-6177

Fax

(360) 671-3574

NPI assigned

Sep 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1528436888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE",
            "address_2": "STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254642",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "439 Breeze St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Craig",
            "state": "CO",
            "postal_code": "816252646",
            "country_code": "US",
            "telephone_number": "970-824-6541",
            "fax_number": "970-824-0313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61136957",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "LSW0009920979",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Washington Kidney Care LLC
• Marie J Washington, SUDP
• Arthur S Watanabe, MD
• Chandra Wati
• Bo James Watins
• Laurel Watjen, LMHC
• Adrienne Watkins, LPC
• Allison Suzette Watkins, LM, MSM

• Clinical Social Worker in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.