Provider Demographics
NPI:1659424729
Name:WATERS, FRANCES S (MSW)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:S
Last Name:WATERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:FRAN
Other - Middle Name:S
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:706 CHIPPEWA SQ STE 205A
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4833
Mailing Address - Country:US
Mailing Address - Phone:906-226-2777
Mailing Address - Fax:906-226-0595
Practice Address - Street 1:706 CHIPPEWA SQ STE 205A
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4833
Practice Address - Country:US
Practice Address - Phone:906-226-2777
Practice Address - Fax:906-226-0595
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010197971041C0700X
MI4101005643106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI80-0892139-0OtherBCBS
MI80-0892139-0OtherBCBS
0M91390Medicare ID - Type Unspecified