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Individual

GARY WATERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LMFT, LADC

Contact information

Practice address
815 EUREKA DR, FRIDAY HARBOR, WA 98250-6910
(360) 317-4066
Mailing address
815 EUREKA DR, FRIDAY HARBOR, WA 98250-6910
(360) 317-4066

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
426-LC
NV
101YS0200X
School Counselor
22343
NV
103TS0200X
School Psychologist
22343
NV
1041C0700X
Clinical Social Worker
000357-C
NV
1041C0700X
Clinical Social Worker
Primary
LW60737867
WA
1041S0200X
School Social Worker
22343
NV
106H00000X
Marriage & Family Therapist
0127
NV
106H00000X
Marriage & Family Therapist
13653
CA

Other

Enumeration date
09/07/2012
Last updated
04/14/2020
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