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General NPI Number Information
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NPI Number | 1902607658
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Entity Type | Organization
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Legal Business Name | WATERS AT PEACE COUNSELING CENTER LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 138 CANAL ST STE 406
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City | POOLER
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State | GA
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Zip | 31322-4048
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Country | US
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Telephone | 912-349-9427
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Fax |
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Provider Business Mailing Address
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Address Line | 105 LIAM CT
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City | GUYTON
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State | GA
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Zip | 31312-7109
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Country | US
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Telephone | 678-643-9822
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Fax |
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Authorized Official
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Title or Position | FOUNDER/DIRECTOR
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Name | MR. LAYTON L WALKER
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Credential | MA, LPC
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Telephone | 912-421-1896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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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