MARY SUSAN WATERS (M.A., L.P.C.) – Professional Counselor, NPI 1093722811

MARY SUSAN WATERS (M.A., L.P.C.) is a healthcare provider. based in Tulsa, Oklahoma. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials M.A., L.P.C.. They hold a License No. 2616 (OK). The NPI Number for MARY SUSAN WATERS (M.A., L.P.C.) is 1093722811

Main info

Female
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
MARY SUSAN WATERS (M.A., L.P.C.)
NPI
1093722811
Phone
(918) 671-2705
Address
8596 E 101ST ST
Enumeration Date
2 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9188729777
Graduation Year
1994 (32 years ago)
PAC ID
9931623790
Group Practice PAC ID
8527962216
Professional Enrollment ID
I20250414002096
Address ID
OK740126004BR8937XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,199 MENTAL HEALTH COUNSELOR in OK

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Provider Addresses for MARY SUSAN WATERS (M.A., L.P.C.)

  • 8596, East 101st Street, Saddle Ridge, Tulsa, Tulsa County, Oklahoma, 74133, United States

    SUITE D

    TULSA, OK 741337034

    Phone: (918) 671-2705

    Fax: (918) 369-7017

    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: 2025-04-14

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
I20250414002096IMental Health CounselorOKTBD

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 74133)

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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: 8527962216View full group profile
NameSpecialtyState
P S Y C H I A T R YOK
Nurse PractitionerOK
Clinical PsychologistOK
Mental Health CounselorOK
Certified Clinical Nurse Specialist (Cns)OK
Mental Health CounselorOK
Clinical PsychologistOK
-OK
Nurse PractitionerMO
Nurse PractitionerOK

Reviews

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Frequently asked questions

What unique ID ties claims to MARY SUSAN WATERS (M.A., L.P.C.)?
NPI 1093722811 is assigned to MARY SUSAN WATERS (M.A., L.P.C.) under the national enumeration system.
Is MARY SUSAN WATERS (M.A., L.P.C.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MARY SUSAN WATERS (M.A., L.P.C.)'s specialty in plain language?
Clinically, the directory lists MARY SUSAN WATERS (M.A., L.P.C.) with Professional Counselor. Clinical services aligned with this taxonomy classification.
Where does public data place MARY SUSAN WATERS (M.A., L.P.C.)?
The snapshot lists Tulsa, Oklahoma for MARY SUSAN WATERS (M.A., L.P.C.); download NPPES for the complete set.
How can I contact MARY SUSAN WATERS (M.A., L.P.C.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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