1. Home
  2. Directory
  3. Illinois
  4. Rock Island
  5. Counselor
  6. NPI Profile

KELLY MIRANDA WATERS
NPI 1093273542
Counselor - Addiction (Substance Use Disorder) in Rock Island, IL

Active since March 04, 2019
2701 17TH ST, ROCK ISLAND, IL 61201(309) 779-2031 Get Directions Write a Review

NPPES record last updated: March 4, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Kelly Miranda Waters NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY MIRANDA WATERS (NPI 1093273542) is an individual addiction (substance use disorder) provider in Rock Island, Illinois and active in the NPI registry since March 2019.

NPPES Registry Identity

NPI1093273542
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELLY MIRANDA WATERS
Location Address2701 17TH STRock Island, IL 61201-5351
Mailing Address2701 17th StRock Island, IL 61201-5351 · (309) 779-2031
Phone(309) 779-2031
Sole ProprietorNo
Enumeration DateMarch 4, 2019
✔ NPI 1093273542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
2701 17TH ST, Rock Island, IL 61201
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. QUANG TUNG NGUYEN M.D.
Internal Medicine
2701 17TH ST, HOSPITALIST PROGRAM
ROCK ISLAND, IL 61201
Rock Island County (309) 779-3100
DEEPTA SHANKAR ATRE STRAND M.D.
Emergency Medicine
2701 17TH ST
ROCK ISLAND, IL 61201
Rock Island County (309) 779-5000
DANIELLE JILLIAN WADDLE LMSW
Social Worker
2701 17TH ST
ROCK ISLAND, IL 61201
Rock Island County (309) 779-2031
ALEXIA SWIFT
Registered Nurse (Psychiatric/Mental Health)
2701 17TH ST
ROCK ISLAND, IL 61201
Rock Island County (309) 779-7500
SAMANTHA GOMAN
Counselor
2701 17TH ST
ROCK ISLAND, IL 61201
Rock Island County (309) 779-2031
MRS. KRISTINE KEAN RN
Registered Nurse (Psychiatric/Mental Health)
2701 17TH ST
ROCK ISLAND, IL 61201
Rock Island County (309) 779-2031
BRITTANY MICHELLE REDMOND
Hospitalist
2701 17TH ST
ROCK ISLAND, IL 61201
Rock Island County (309) 779-5000
IBRAHIM K TARAWNEH BA
Counselor (Mental Health)
2701 17TH ST
ROCK ISLAND, IL 61201
Rock Island County (309) 779-3006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Waters's NPI number?

The NPI number for Kelly Waters is 1093273542. It was assigned to this individual provider in the NPPES registry on March 4, 2019.

Where is Kelly Waters located?

Kelly Waters practices at 2701 17th St, Rock Island, IL 61201. The listed phone number is (309) 779-2031.

What is Kelly Waters's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kelly Waters was last updated on March 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.