MEDICARE: LIVING WATER COUNSELING AND BODYWORK PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1861323578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING WATER COUNSELING AND BODYWORK PLLC

Provider Business Mailing Address
First Line	:	50 VIEWMONT CV
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-7863
Country	:	US
Telephone Number	:	731-225-1575
Fax Number	:	731-664-8100

Provider Business Practice Location Address
First Line	:	3566 HIGHWAY 45 N STE D
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-7890
Country	:	US
Telephone Number	:	731-225-1575
Fax Number	:	731-664-8100

Authorized Official
Title or Position	:	OWNER
Name	:	EVELYN MARIE STEETS
Credential	:	LCSW
Telephone Number	:	731-225-1575

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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