# WATER'S EDGE PSYCHOTHERAPY AND WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285055376
- **Authorized official:** LINDA WACKERMAN MSW (PARTNER)
- **Authorized official phone:** (206) 963-4907

## Contact information

- **Practice address:** 47 MAPLE ST, BURLINGTON, VT 05401-4861
- **Practice address phone:** (802) 651-7807
- **Mailing address:** 47 MAPLE ST STE 331, BURLINGTON, VT 05401-5097
- **Mailing address phone:** (206) 963-4907
- **Mailing address fax:** (802) 861-0010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | VT | — |
| 1041C0700X | Clinical Social Worker | — | VT | Yes |

## Other

- **Enumeration date:** 12/17/2013
- **Last updated:** 02/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1006773 | — | VT |
| 05 | — | 1018888 | — | VT |
| 05 | — | 1285055376 | — | VT |