Individual
MS. CAROL A WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, CAADC
Contact information
Practice address
122 N MAPLE ST, ITHACA, MI 48847-1024
(989) 388-4185
(989) 388-4187
Mailing address
5131 CORVALLIS DR, MOUNT PLEASANT, MI 48858-7935
(989) 289-5632
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
6401010542
MI
Other
Enumeration date
12/27/2006
Last updated
07/21/2022
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