Amy Waterman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60893230 Issued in WA

Practice address

1413 W York Ave
Spokane, WA 99205-3568

Phone

(509) 951-0995

NPI assigned

Mar 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stillwater Mental Health Counseling PLLC

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1760210074
  NPD (past) Authorized official

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1730715939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 W YORK AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992053568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W YORK AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992053568",
            "telephone_number": "509-951-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "AMY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60893230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "LW60893230",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myleni Gonzales Washington, BCBA, LBA
• Maureen Wasonga
• Ethan Wasyluka
• Raven Water Blossom
• Waterford on the South Hill
• Christopher Ashton Waters, PH.D.
• Terrell A Waters
• Courteney Ann Waterworth, RN
• Amanda Rose Watilo, MSN
• Calysta Watkins

• Clinical Social Worker in Spokane, WA
• Providers in Spokane, 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 Mar 19, 2020; 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.