Individual provider Active NPI

Christopher Brock Waters, LPC

  • Professional Counselor
  • Monroe, LA
National Provider Identifier
1720396328
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4280 Issued in LA
Practice address
600 Forsythe Ave
C/O Guidance Office
Monroe, LA 71201-4060
Phone
(318) 323-2237
Fax
(318) 323-1737
NPI assigned
Sep 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4280 LA Primary

Addresses

Primary practice location

600 Forsythe Ave
C/O Guidance Office
Monroe, LA 71201-4060

Mailing address

600 Forsythe Ave
C/O Guidance Office
Monroe, LA 71201-4060
Phone (318) 323-2237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240219002532 LA Practitioner - Mental Health Counselor 4385092253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5159 Hwy 4 E
Columbia Behavioral Health Clinic
Columbia, LA 71418-3540
Phone (318) 649-2333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4280LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Delta Human Services Authority CurrentSince Jan 15, 2024 Accepting new patients
Northeast Delta Human Services Authority CurrentSince Jan 15, 2024 Accepting new patients
Northeast Delta Human Services Authority Current Accepting new patients

Locations

451 E Madison Ave
Bastrop, LA 71220
Phone (318) 283-0868

5159 Highway 4 E
Columbia, LA 71418
Phone (318) 649-2333

4800 S Grand St
Monroe, LA 71202
Phone (318) 362-3339

2513 Ferrand St
Monroe, LA 71201
Phone (318) 362-3270

2525 Ferrand St
Monroe, LA 71201
Phone (318) 362-3153

901 White St
Ruston, LA 71270
Phone (318) 251-4125

1012 Johnson St
Tallulah, LA 71282
Phone (318) 574-1713

1301 Landis St
#B
Winnsboro, LA 71295
Phone (318) 435-2146

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1720396328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 FORSYTHE AVE",
            "address_2": "C/O GUIDANCE OFFICE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712014060",
            "telephone_number": "318-323-2237",
            "fax_number": "318-323-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FORSYTHE AVE",
            "address_2": "C/O GUIDANCE OFFICE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712014060",
            "telephone_number": "318-323-2237",
            "fax_number": "318-323-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CHRISTOPHER",
        "middle_name": "BROCK",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-16",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "4280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.