Individual
ANDREW EMORY WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LMHC, LADC
Contact information
Practice address
2200 1ST AVE S, MINNEAPOLIS, MN 55404-3401
(612) 767-0307
Mailing address
6375 NW 77TH PL, PARKLAND, FL 33067-2405
(845) 729-9157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304111
MN
101YM0800X
Mental Health Counselor
CC02151
MN
101YM0800X
Mental Health Counselor
Primary
MH18040
FL
Other
Enumeration date
08/07/2020
Last updated
11/24/2021
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