Healthcare Provider Details

I. General information

NPI: 1861320988
Provider Name (Legal Business Name): WATERS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 24TH ST
OGDEN UT
84401-1528
US

IV. Provider business mailing address

1334 25TH ST
OGDEN UT
84401-2811
US

V. Phone/Fax

Practice location:
  • Phone: 801-971-0447
  • Fax:
Mailing address:
  • Phone: 801-971-0447
  • Fax:

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: MS. TAWNA WATERS
Title or Position: OWNER
Credential: CMHC
Phone: 801-971-0447