DR. TANYA RENE WATERS (NPI# 1275785453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275785453 |
| Entity Type | Individual |
| Full Name | DR. TANYA RENE WATERS |
| Other Name | TANYA RENE SHANKWEILER |
| Credential | PSY.D. |
| Practice Address |
807 W Broad St Bethlehem PA 18018-5223 |
| Mailing Address |
1151 Jordan Blvd Whitehall PA 18052-5227 |
| Practice Telephone | 4845476645 |
| Mailing Telephone | 4845476645 |
| Enumeration Date | 2008-10-19 |
| Last Update Date | 2020-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS016512 | PA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1040 Chestnut St, Emmaus, PA 180491952 | 6109665188 | 6109660466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073627592 | Tanya Waters | Advanced Practice Midwife | 183 Saint Paul St, Burlington, VT 05401-4636 | 2006-08-19 |
| Street Address |
807 W BROAD ST |
| City | BETHLEHEM |
| State | PA |
| Zip Code | 18018-5223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927566 | Denise Patricia Gooden | Counselor | 807 W Broad St, Bethlehem, PA 18018-5223 | 2020-09-20 |
| 1063963361 | Sarah Mcinerney | Counselor | 807 W Broad St, Bethlehem, PA 18018-5223 | 2016-10-21 |
| 1982033643 | Kimberly Fredericks | Counselor | 807 W Broad St, Bethlehem, PA 18018-5223 | 2013-11-04 |
| 1851730766 | Brittany Azzolina | Counselor | 807 W Broad St, Bethlehem, PA 18018-5223 | 2013-06-25 |
| 1205063609 | Mojca Dusold | Counselor | 807 W Broad St, Bethlehem, PA 18018-5223 | 2009-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373292 | Jade Madison Hennessy | Specialist/Technologist | Moravian College, 1200 Main Street, Bethlehem, PA 18018 | 2019-06-03 |
| 1780106179 | Courtney Jane Kruscavage | Specialist/Technologist | 641 Dellwood Street, Bethlehem, PA 18018 | 2017-07-07 |
| 1205357936 | Balanced Body Therapeutic Massage, LLC | Massage Therapist | 227 W Broad St Ste 102, Bethlehem, PA 18018 | 2017-07-03 |
| 1033567599 | Jessamine Martin | Counselor | 1 East Broad Street, Suite 510, Bethlehem, PA 18018 | 2016-05-25 |
| 1841650041 | Akhi Saha | Internal Medicine | 325 W Broad St Fl 1, Bethlehem, PA 18018 | 2016-03-01 |
| 1063804193 | Paul Minh Le | Internal Medicine | 800 Eaton Ave Ste B, Bethlehem, PA 18018 | 2015-02-26 |
| 1578962841 | Elizabeth Veronica Weiss Iobst | Counselor | 1754 W. Broad St., Bethlehem, PA 18018 | 2014-08-22 |
| 1255771739 | Inner Resources Counseling Inc | Counselor | 807 West Broad St, Bethlehem, PA 18018 | 2013-06-28 |
| 1437404878 | St Luke Hospital | General Acute Care Hospital | 1956 C Allwood Dr., Bethlehem, PA 18018 | 2012-07-23 |
| 1275802944 | St. Luke's Physician Group, Inc | Ophthalmology | 800 Eaton Avenue, Suite 101, Bethlehem, PA 18018 | 2011-12-23 |
| Find all providers in zip 18018 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114402682 | Anna Violet Sheedy | Psychologist | 1 W Broad St Ste 810, Bethlehem, PA 18018-5877 | 2018-09-30 |
| 1235612482 | Eleanor Benner | Psychologist | 1 Bethlehem Plz Ste 8101, Bethlehem, PA 18018-5754 | 2018-09-13 |
| 1366959488 | Stephen J Sell | Psychologist | 35 E Elizabeth Ave Ste 26, Bethlehem, PA 18018-6505 | 2018-01-10 |
| 1063950517 | Brooke Hoffman | Psychologist | 4439 Harriet Ln, Bethlehem, PA 18017-8418 | 2017-02-04 |
| 1366844946 | Julie Amato | Psychologist | 3400 Bath Pike Ste 302, Bethlehem, PA 18017-2485 | 2014-09-25 |
| 1760515712 | Nancy Ann Killackey | Psychologist | 4383 Hecktown Road, Bethlehem, PA 18020 | 2007-03-13 |
| 1043322829 | David Walter Durka | Psychologist | Dr D Durka 3201 Highfield Dr Suite H Bethlehem Pa 18020, Bethlehem, PA 18020-1113 | 2006-08-31 |
| 1154341246 | David R. Youngelman | Psychologist | 3864 Adler Place, Suite 500, Bethlehem, PA 18017 | 2006-07-20 |
| 1801849583 | Joel B. Ingersoll | Psychologist | 227 W Broad St, Suite 205, Bethlehem, PA 18018-5570 | 2006-05-17 |
| 1427058437 | Abraham G. Haklay | Psychologist | 140 E Broad St, 1st Floor, Bethlehem, PA 18018-6220 | 2005-08-01 |
| Find all providers in BETHLEHEM | ||||
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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.