Individual provider Active NPI

Latonya J Watters, LPC

  • Professional Counselor
  • Rome, GA
National Provider Identifier
1730405507
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
004681 Issued in GA
Practice address
15 E 5TH Ave # A4
Rome, GA 30161-1722
Phone
(404) 583-2439
Fax
(706) 291-1870
NPI assigned
Apr 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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 004681 GA Primary

Addresses

Primary practice location

15 E 5TH Ave # A4
Rome, GA 30161-1722

Mailing address

325 Grant Rd NE
Armuchee, GA 30105-2622
Phone (404) 583-2439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240318001497 GA Practitioner - Mental Health Counselor 7618314337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 E 5TH Ave
A4
Rome, GA 30161-1722
Phone (404) 583-2439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004681GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Watters Counseling & Consulting, LLC Professional CurrentSince Feb 3, 2023 Accepting new patients

Locations

15 E 5th Ave
#A4
Rome, GA 30161
Phone (404) 583-2439

Organizations & group practices 1

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1730405507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 GRANT RD NE",
            "city": "ARMUCHEE",
            "state": "GA",
            "postal_code": "301052622",
            "telephone_number": "404-583-2439",
            "fax_number": "706-291-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E 5TH AVE # A4",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301611722",
            "telephone_number": "404-583-2439",
            "fax_number": "706-291-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERS",
        "first_name": "LATONYA",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "004681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.