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General NPI Number Information
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NPI Number | 1023953122
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Entity Type | Organization
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Legal Business Name | LIVING WATER: WHITE MOUNTAIN COUNSELING, LLC
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 540 S RIDGE DR
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City | SHOW LOW
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State | AZ
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Zip | 85901-5293
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Country | US
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Telephone | 908-418-1765
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Fax |
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Provider Business Mailing Address
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Address Line | 540 S RIDGE DR
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City | SHOW LOW
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State | AZ
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Zip | 85901-5293
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Country | US
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Telephone | 908-418-1765
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Fax |
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Authorized Official
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Title or Position | LICENSED INDEPENDENT ADDICTION COUN
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Name | CINDI CLARICE KUTSOP
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Credential | LIAC
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Telephone | 908-418-1765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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