Professional Addiction Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROFESSIONAL ADDICTION SERVICES LLC

Practice address

204 N Cedar St Ste 100
Summerville, SC 29483-6453

Phone

(843) 821-2480

Fax

(843) 875-3149

NPI assigned

Oct 2, 2018

Organization subpart

No

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

Authorized official

Name

Kathleen Waters, ANPNPI 1295028959

Title

Owner

Phone

(254) 760-9603

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Anne Waters, APRN

  • Adult Health Nurse Practitioner
  • Summerville, SC
  • NPI 1295028959
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1922583277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 BRICK KILN DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294835415",
            "telephone_number": "254-760-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N CEDAR ST STE 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836453",
            "telephone_number": "843-821-2480",
            "fax_number": "843-875-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ADDICTION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-760-9603",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Summerville, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.