John M Waterman, CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

25901 Issued in NY

Practice address

475 E Main St
Suite 1
Patchogue, NY 11772-3121

Phone

(631) 363-2001

Fax

(631) 702-8050

NPI assigned

Jan 7, 2015

Last updated

Jan 7, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1891183216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 S COUNTRY RD",
            "city": "E PATCHOGUE",
            "state": "NY",
            "postal_code": "117725550",
            "telephone_number": "631-371-2680",
            "fax_number": "631-702-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 E MAIN ST",
            "address_2": "SUITE 1",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723121",
            "telephone_number": "631-363-2001",
            "fax_number": "631-702-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "25901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ward-Quinn, LMSW
• Paula K Waring, LCSW-R, CASAC
• Allan Warren
• Diane Marie Warren, RN
• Colleen M Washington, LMHC
• Lindsay Wedell
• Richard Michael Weintraub, DDS
• Kelly Welch
• Wellcare Medical of Long Island PLLC (Pure Medical)
• Wellcare Medical of New York PLLC (Medical Pureness)

• Addiction (Substance Use Disorder) Counselor in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.