Clearwaters Health and Wellness

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

26NO06244100 Issued in NJ

Legal business name

CLEARWATERS HEALTH AND WELLNESS

Practice address

615 Hope Rd
Building 5B
Eatontown, NJ 07724-1277

Phone

(732) 982-2673

Fax

(848) 456-4599

NPI assigned

Mar 23, 2016

Last updated

Mar 23, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Maryceline Lott, RN

Title

Registered Nurse

Phone

(732) 982-2673

Specialties & licenses 1

Addresses

Tax ID family

Clear Waters Health and Wellness PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Clear Waters Health and Wellness PC

  • Health Service Clinic/Center
  • Tinton Falls, NJ
  • NPI 1104200484
  NPD tax ID

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1558723148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD",
            "address_2": "BUILDING 5B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-982-2673",
            "fax_number": "848-456-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD",
            "address_2": "BUILDING 5B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-982-2673",
            "fax_number": "848-456-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATERS HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "LOTT",
        "authorized_official_first_name": "MARYCELINE",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "732-982-2673",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "26NO06244100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianna Cianfano
• Nicole Elizabeth Cichetti, ANP
• Alfonso Ciervo, MD
• Leah Ciner, LCSW
• Larisa M Citsay, MA
• Dylan Cleary
• Kimberly Clemente, R.N, APN, C
• CNJ Specialty Surgical Associate (Central Jersey Specialty Surgical Associates)
• Leah Cohen, PA-C
• Rebecca Ellen Cohen, COTA

• Addiction (Substance Use Disorder) Registered Nurse in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.