Healthcare Provider Details

I. General information

NPI: 1861323578
Provider Name (Legal Business Name): LIVING WATER COUNSELING AND BODYWORK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3566 HIGHWAY 45 N STE D
JACKSON TN
38305-7890
US

IV. Provider business mailing address

50 VIEWMONT CV
JACKSON TN
38305-7863
US

V. Phone/Fax

Practice location:
  • Phone: 731-225-1575
  • Fax: 731-664-8100
Mailing address:
  • Phone: 731-225-1575
  • Fax: 731-664-8100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: EVELYN MARIE STEETS
Title or Position: OWNER
Credential: LCSW
Phone: 731-225-1575