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General NPI Number Information
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NPI Number | 1710792387
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Entity Type | Individual
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Provider Name | REBECCA LYNN WATERS
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 79001 AL HIGHWAY 77
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City | LINCOLN
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State | AL
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Zip | 35096-4073
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Country | US
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Telephone | 256-315-5271
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Fax |
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Provider Business Mailing Address
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Address Line | 568 AVONDALE LN
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City | PELL CITY
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State | AL
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Zip | 35128-7741
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Country | US
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Telephone | 205-473-5067
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | ALC05197
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License Number State | AL
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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 | ALC05197
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License Number State | AL
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