MARY JOHNETT WATERMAN (NPI# 1275642928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275642928 |
| Entity Type | Individual |
| Full Name | MARY JOHNETT WATERMAN |
| Credential | LCSW |
| Practice Address |
820 Jordan St Suite 220 Shreveport LA 71101-4519 |
| Practice Telephone | 3182268753 |
| Practice Fax Number | 3182268754 |
| Mailing Telephone | 3182268753 |
| Mailing Fax Number | 3182268754 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
2689 | LA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982070736 | Mary Waterman | Behavioral Analyst | 219 S Chase St, Wheaton, IL 60187-5544 | 2015-08-17 |
| 1780865238 | Mary Louise Waterman | Physical Therapist | Criterion-stoneham Early Intervention Program, 8 Henshaw St, Woburn, MA 01801 | 2007-11-26 |
| 1033581590 | Mary C Waterman | Nurse Practitioner | 4204 Gardendale St, Ste 312, San Antonio, TX 78229-3132 | 2015-10-23 |
| Street Address |
820 JORDAN ST SUITE 220 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139098 | Red River Orthotic Specialists, LLC | Prosthetic/Orthotic Supplier | 820 Jordan St, Suite 110, Shreveport, LA 71101-4518 | 2005-07-22 |
| 1396269171 | Ulissa Samone Edwards | Counselor | 820 Jordan St, Shreveport, LA 71101-4518 | 2017-08-02 |
| 1154845196 | Kelvin Wayne Latson | Counselor | 820 Jordan St, Shreveport, LA 71101-4518 | 2017-08-01 |
| 1033633201 | Monica Burns | Counselor | 820 Jordan St, Ste. 507, Shreveport, LA 71104 | 2017-07-31 |
| 1811410376 | Aaliyah Janee' Watkins | Counselor | 820 Jordan St, Shreveport, LA 71101-4518 | 2017-07-17 |
| 1275983363 | Morris Crichlow | Counselor | 820 Jordan St, Suite 204, Shreveport, LA 71101-4518 | 2016-06-20 |
| 1730536202 | Innerlight Wellness, LLC | Counselor | 820 Jordan St, Suite 204, Shreveport, LA 71101-4518 | 2016-05-15 |
| 1548661440 | Tiffany Alyce Roe | Nurse Practitioner | 820 Jordan St, Suite 201, Shreveport, LA 71101-4518 | 2014-09-10 |
| 1861812307 | Carol Hamilton Brill | Counselor | 820 Jordan St, Suite 510-c, Shreveport, LA 71101-4518 | 2014-04-23 |
| 1659701209 | Latoya Houston | Nurse Practitioner | 820 Jordan St, Suite 501, Shreveport, LA 71101-4518 | 2013-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568083293 | Mickey Dawnell Lathon | Social Worker | 8823 Chadwick Dr, Shreveport, LA 71129-5124 | 2020-05-05 |
| 1649818303 | Jacinta Tiane Lafleur | Social Worker | 9806 Kingston Rd, Shreveport, LA 71118-5320 | 2019-12-12 |
| 1619537651 | The Therapeutic & Restorative Village | Social Worker | 820 Jordan St Ste 315c, Shreveport, LA 71101-4512 | 2019-06-20 |
| 1700365996 | Turning Point Counseling Services LLC | Social Worker | 234 Mayo Rd, Shreveport, LA 71106-7916 | 2018-08-09 |
| 1528546983 | Lisa Haulmark | Social Worker | 2350 Levy St, Shreveport, LA 71103-3656 | 2018-07-29 |
| 1134625932 | Nikkole Weiss | Social Worker | 3000 Knight St Bldg 5, Shreveport, LA 71105-2566 | 2018-04-02 |
| 1659875219 | Tammi Layne Rider | Social Worker | 4859 Dixie Garden Loop, Shreveport, LA 71105-4035 | 2018-03-20 |
| 1679088355 | Takandra A Johnson | Social Worker | 8700 Millicent Way Apt 605, Shreveport, LA 71115-2254 | 2017-12-04 |
| 1801347232 | James Ross Sr. | Social Worker | 1010 Creswell Ave, Shreveport, LA 71101-3918 | 2016-10-20 |
| 1558713438 | Angela White | Social Worker | 9315 Midvale Dr, Shreveport, LA 71118-3554 | 2016-07-05 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.