| Doctor Name: | MRS. JOANNE WATERS |
| NPI Number: | 1356561310 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | R056614 |
| Business Practice Address: | 296 N Main St Ste 1 Sayville, NY - 117822515 |
| Business Phone Number: | 6317869361 |
| Business Fax Number: | 6315815467 |
| Mailing Address: | 49 Dixie Ln, EAST ISLIP |
| State: | NY |
| Postal Code: | 117302615 |
| Phone Number: | 6316501628 |
| Fax Number: | 6315815467 |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R056614 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |