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General NPI Number Information
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NPI Number | 1699110015
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Entity Type | Individual
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Provider Name | LASHAWN JANELL WATERS MS
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Gender | Female
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 709 N BROOM ST APT 6
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City | WILMINGTON
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State | DE
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Zip | 19805-3160
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Country | US
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Telephone | 610-761-2129
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CORPORATE CIR STE 201
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City | NEW CASTLE
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State | DE
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Zip | 19720-2418
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Country | US
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Telephone | 302-276-1494
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0000785
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License Number State | DE
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