NPIMap

Organization Active NPI

Living Water Counseling Center, Inc.

  • Clinical Social Worker
  • Holyoke, MA
National Provider Identifier
1922445535
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114516 Issued in MA
Legal business name
LIVING WATER COUNSELING CENTER, INC.
Practice address
94 Suffolk St
Holyoke, MA 01040-4458
Phone
(413) 315-3194
Fax
(413) 322-8404
NPI assigned
May 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Authorized official

Name
Mr. Frank H Wotton III, LICSE, LADC 1
Title
President
Phone
(413) 315-3194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 114516 MA Primary

Addresses

Primary practice location

94 Suffolk St
Holyoke, MA 01040-4458

Mailing address

94 Suffolk St
Holyoke, MA 01040-4458
Phone (413) 315-3194

Other identifiers 6

IdentifierTypeStateIssuer
241903OtherMATUFT
P09114OtherMABLUE CROSS BLUE SHIELD
109497OtherMABEACON
45208OtherMAHEALTH NEW ENGLAND
0005602OtherMAMEDICARE
6724849OtherMAAETNA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369267200000",
    "number": "1922445535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 SUFFOLK ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010404458",
            "telephone_number": "413-315-3194",
            "fax_number": "413-322-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 SUFFOLK ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010404458",
            "telephone_number": "413-315-3194",
            "fax_number": "413-322-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATER COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-23",
        "last_updated": "2013-05-23",
        "status": "A",
        "authorized_official_last_name": "WOTTON",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-315-3194",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LICSE, LADC 1"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFT",
            "identifier": "241903",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P09114",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON",
            "identifier": "109497",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "45208",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0005602",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6724849",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; 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.