Living Waters Counseling and Consulting Services NFP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LIVING WATERS COUNSELING AND CONSULTING SERVICES NFP

Practice address

4550 W 103Rd St Ste 302B
Oak Lawn, IL 60453-4868

Phone

(773) 280-5675

Fax

(773) 873-5333

NPI assigned

Oct 22, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Renee Lee, LCSW, CADC

Title

Chief Executive Officer

Phone

(708) 271-5370

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Living Waters Counseling and Consulting Services Other name

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1841899671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8157 S ELIZABETH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606203857",
            "telephone_number": "708-271-5370",
            "fax_number": "773-873-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 W 103RD ST STE 302B",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534868",
            "telephone_number": "773-280-5675",
            "fax_number": "773-873-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS COUNSELING AND CONSULTING SERVICES NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "708-271-5370",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, CADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "326549937001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://livingwaters-ccs.org/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4550 W 103rd St Ste 302B",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604534868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Living Waters Counseling and Consulting Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Living Waters Counseling and Consulting Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Social Worker in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.