Living Waters Therapeutic Alliance Inc
NPI 1174207609 · Mental Health Counselor · Suffolk, VA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Living Waters Therapeutic Alliance Inc is a Mental Health Counselor organization in Suffolk, VA (NPI 1174207609).
Provider details
- NPI number
- 1174207609
- Entity type
- Organization
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Charlena Correll, Director(757) 405-7519
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-06-14
- Last updated
- 2024-12-02
- Certified
- 2024-12-02
Frequently asked questions
- What is Living Waters Therapeutic Alliance Inc's NPI number?
- Living Waters Therapeutic Alliance Inc's National Provider Identifier (NPI) is 1174207609, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Living Waters Therapeutic Alliance Inc?
- Living Waters Therapeutic Alliance Inc is classified in the NPPES registry as Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Living Waters Therapeutic Alliance Inc located?
- Living Waters Therapeutic Alliance Inc's practice location on file with NPPES is 2570 River Watch Dr, Suffolk, VA 23434-8669.
- What is Living Waters Therapeutic Alliance Inc's phone number?
- The practice phone number listed in the NPPES registry for Living Waters Therapeutic Alliance Inc is (757) 270-3976.
- Does Living Waters Therapeutic Alliance Inc accept Medicare?
- Living Waters Therapeutic Alliance Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Living Waters Therapeutic Alliance Inc?
- The authorized official listed on Living Waters Therapeutic Alliance Inc's NPPES record is Charlena Correll, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Living Waters Therapeutic Alliance Inc's NPI active?
- Yes — Living Waters Therapeutic Alliance Inc's NPI (1174207609) is active in the NPPES registry as of the last update on 2024-12-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.