Bluewater Behavioral Health Inc
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Niceville, FL
NPI 1922562628 · NPPES record last updated Jun 5, 2026
Key facts
- NPI
- 1922562628
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- BLUEWATER BEHAVIORAL HEALTH INC
- Practice address
- 4400 E Highway 20 Ste 208
Niceville, FL 32578-9735 - Phone
- (575) 520-1230
- Fax
- (773) 492-8765
- NPI assigned
- Jan 27, 2019
- Organization subpart
- No
Authorized official
- Name
- Leigh Gayle Powers, DNP, APRN, PMHNP-BC
- Title
- Owner/Provider
- Phone
- (850) 797-2598
Practitioners 17
-
Mariah Boyer, LCSW
-
Claritza Bunten, MS, LMHC
-
Grace Francis, ARNP
-
Tara Nicole Kidd, MSN, APRN, PMHNP-BC
-
Kristen Nicole Peterman, APRN, PMHNP-BC
-
Leigh Gayle Powers, DNP
-
Christopher Kyle Totten, APRN
-
Dana Wallace, LCSW, LICSW
-
Tonya Anderson, APRN
-
Cathy Jean Correa, SLP
-
Tasha Jeanette Singh, LCSW
-
Enri Fort, MS,CCC-SLP
-
Kelly A Kugler, LMHC
-
Kimberly Ret, APRN
-
Karen P Reed, LCSW
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2276299 | Bluewater Behavioral Health Inc | Certificate of waiver | Feb 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190326000623 | FL | Part B Supplier - Clinic/Group Practice | 3274873435 |
Receives reassigned benefits from 18 practitioners Practice locations: Fort Walton Beach, FL; Niceville, FL |
National Provider Directory
Locations
4400 E Highway 20
Niceville, FL 32578
Phone (850) 279-4104
4400 E Highway 20
Ste 208
Niceville, FL 32578
Phone (507) 972-5988
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
4400 E Highway 20 Ste 208
Niceville, FL 32578-9735
Mailing address
4400 E Highway 20 Ste 208
Niceville, FL 32578-9735
Phone (850) 797-2598
Other practice location 1
4400 E Highway 20 Ste 306
Niceville, FL 32578-7703
Phone (850) 797-2598
Other practice location 2
907 Mar Walt Dr Ste 2013
Fort Walton Beach, FL 32547-6756
Phone (850) 797-9438
Other providers in Niceville, FL
- Caroline Blauvelt
- Melissa Blizzard
- Blue Sky DME Inc
- Bluewater Bay Dental, PA
- Bluewater Bay Urology LLC
- Bluewater Behavioral Services
- Bluewater Behavioral Services
- Bluewater Cardiology LLC
- Bluewater Orthopedics PA
- Bluewater Orthopedics, P.a.
All providers in Niceville, FL · Psychiatric/Mental Health Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.