TANYA RENE WATERS
TANYA RENE SHANKWEILER · Psychologist (Clinical)

Address: 807 W Broad St, Bethlehem, PA 18018-5223

TANYA RENE WATERS (NPI# 1275785453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275785453
Entity Type Individual
Full Name DR. TANYA RENE WATERS
Other Name TANYA RENE SHANKWEILER (Former Name)
Gender Female
Credential PSY.D.
Other Credential PSYD
Practice Address 807 W Broad St
Bethlehem
PA 18018-5223
Practice Telephone 4845476645
Mailing Address 1151 Jordan Blvd
Whitehall
PA 18052-5227
Mailing Telephone 4845476645
Certification Date 2020-10-21
Enumeration Date 2008-10-19
Last Update Date 2020-10-21
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 103TC0700X Psychologist
Specialization: Clinical
PS016512 PA Behavioral Health & Social Service Providers

Provider Secondary Practice Locations

Address Telephone Number Fax Number
1040 Chestnut St, Emmaus, PA 180491952 6109665188 6109660466

Office Location

Street Address 807 W BROAD ST
City BETHLEHEM
State PA
Zip Code 18018-5223

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205063609 Mojca Dusold · Mojca Branc Counselor - Mental Health 807 W Broad St, Bethlehem, PA 18018-5223 2009-06-12
1982033643 Kimberly Fredericks Counselor - Professional 807 W Broad St, Bethlehem, PA 18018-5223 2013-11-04
1053927566 Denise Patricia Gooden · Denise Gooden Counselor - Professional 807 W Broad St, Bethlehem, PA 18018-5223 2020-09-20
1851730766 Brittany Azzolina Counselor - Professional 807 W Broad St, Bethlehem, PA 18018-5223 2013-06-25
1063963361 Sarah Mcinerney Counselor - Mental Health 807 W Broad St, Bethlehem, PA 18018-5223 2016-10-21

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1326353954 Fassmed Equipment & Supplies, Inc · Fassmed, Inc Durable Medical Equipment & Medical Supplies 1421 Center Street, Bethlehem, PA 18018 2010-08-06
1356515902 Brian K Altenbach Counselor - Professional 804 W Broad St, Bethlehem, PA 18018 2008-04-15
1255771739 Inner Resources Counseling Inc Counselor - Professional 807 West Broad St, Bethlehem, PA 18018 2013-06-28
1215190871 Jessica Marie Delong Occupational Therapy Assistant 634 East Broad Street, Rehabcare Moravian Village, Bethlehem, PA 18018 2008-07-03
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1013114461 Stephen Todd Olex Internal Medicine - Cardiovascular Disease 1469 8th Ave, Bethlehem, PA 18018 2007-06-29
1578962841 Elizabeth Veronica Weiss Iobst Counselor - Professional 1754 W. Broad St., Bethlehem, PA 18018 2014-08-22
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1962665513 Mark I Lischner Anesthesiology 1 W Broad St Ste 506, Bethlehem, PA 18018 2008-07-03
1487869830 Regina Maria Cudemo Bogle · Regina Cudemo Smock Psychiatry & Neurology - Psychiatry 618 Fourth Ave, # 206, Bethlehem, PA 18018 2007-05-11
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285229021 Briana Luppino Psychologist - Clinical 105 Saucon View Dr, Bethlehem, PA 18015-5075 2021-03-03
1114402682 Anna Violet Sheedy Psychologist - Clinical 1 W Broad St Ste 810, Bethlehem, PA 18018-5877 2018-09-30
1235612482 Eleanor Benner Psychologist - Clinical 1 Bethlehem Plz Ste 8101, Bethlehem, PA 18018-5754 2018-09-13
1366959488 Stephen J Sell Psychologist - Clinical 35 E Elizabeth Ave Ste 26, Bethlehem, PA 18018-6505 2018-01-10
1063950517 Brooke Hoffman Psychologist - Clinical 4439 Harriet Ln, Bethlehem, PA 18017-8418 2017-02-04
1366844946 Julie Amato Psychologist - Clinical 3400 Bath Pike Ste 302, Bethlehem, PA 18017-2485 2014-09-25
1003011081 Ziona Brotleit Psychologist - Clinical 3005 Brodhead Rd, Suite 104, Bethlehem, PA 18020-9201 2007-06-19
1760515712 Nancy Ann Killackey Psychologist - Clinical 4383 Hecktown Road, Bethlehem, PA 18020 2007-03-13
1659401693 Kathleen Mary Fallon Kline · K Fallon Kline Psychologist - Clinical 2551 Baglyos Circle, Suite A18 Lehigh Valley Professional Center, Bethlehem, PA 18020 2007-03-07
1043322829 David Walter Durka Psychologist - Clinical Dr D Durka 3201 Highfield Dr Suite H Bethlehem Pa 18020, Bethlehem, PA 18020-1113 2006-08-31
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City BETHLEHEM
Zip Code 18018

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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