MARK O WATERS (LPC, CAADC) – Professional Counselor, NPI 1740636745

MARK O WATERS (LPC, CAADC) is a healthcare provider. based in Alpena, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC, CAADC. They hold a License No. C-03793 (MI). The NPI Number for MARK O WATERS (LPC, CAADC) is 1740636745

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MARK O WATERS (LPC, CAADC)
NPI
1740636745
Phone
(989) 340-2131
Address
112 ARBOR LN
Enumeration Date
9 May 2016
Last Update Date
11 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2016 (10 years ago)
PAC ID
7012366289
Group Practice PAC ID
6002265261
Professional Enrollment ID
I20231213001735
Address ID
MI497071302Al112XXLNXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:10State licenses:2Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for MARK O WATERS (LPC, CAADC)

  • 112 ARBOR LN

    ALPENA, MI 497071302

    Phone: (989) 340-2131

    Fax: (989) 340-2168

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231213001735IMental Health CounselorMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49707)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002265261View full group profile
NameSpecialtyState
Mental Health CounselorMI

Reviews

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Frequently asked questions

How do payers reference MARK O WATERS (LPC, CAADC)?
For MARK O WATERS (LPC, CAADC), use NPI 1740636745 as the unique 10-digit identifier.
Active or inactive — what applies to MARK O WATERS (LPC, CAADC)?
You should see MARK O WATERS (LPC, CAADC) as active in CMS-hosted NPPES data.
What expertise is attributed to MARK O WATERS (LPC, CAADC)?
MARK O WATERS (LPC, CAADC)'s specialty line reads Professional Counselor. Clinical services aligned with this taxonomy classification.
What locale is associated with MARK O WATERS (LPC, CAADC)?
Directory geography for MARK O WATERS (LPC, CAADC) centers on Alpena, Michigan.
Can I trust this NPI listing for MARK O WATERS (LPC, CAADC)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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