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IVON L WATERS PCLC
NPI 1285310482
Counselor - Professional in Great Falls, MT

Active since June 23, 2023PECOS Enrolled
81 TREASURE STATE DR, GREAT FALLS, MT 59404(406) 402-6400 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 5, 2023, Jun 23, 2023 (2 updates tracked since 2023).

About Ivon L Waters Pclc NPPES

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

IVON L WATERS PCLC (NPI 1285310482) is an individual professional provider in Great Falls, Montana, licensed in Montana (BBH-PCLC-LIC-44130) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1285310482
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameIVON L WATERSCredential: PCLC
Location Address81 TREASURE STATE DRGreat Falls, MT 59404-3454
Mailing Address81 Treasure State DrGreat Falls, MT 59404-3454
Phone(406) 402-6400
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 23, 2023
Last NPPES UpdateJuly 5, 20232 updates tracked since enumeration
NPPES CertifiedJuly 5, 2023
✔ NPI 1285310482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MT · BBH-PCLC-LIC-44130
81 TREASURE STATE DR, Great Falls, MT 59404
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Other Names 1

Former Name (1)Ivan L Wodarz

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ivon L Waters Pclc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9638634017
PECOS Enrollment IDI20260717000171
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Ivon Waters's NPI number?

The NPI number for Ivon Waters is 1285310482. It was assigned to this individual provider in the NPPES registry on June 23, 2023. The provider is also known as Ivan L Wodarz.

Where is Ivon Waters located?

Ivon Waters practices at 81 Treasure State Dr, Great Falls, MT 59404. The listed phone number is (406) 402-6400.

What is Ivon Waters's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Ivon Waters enrolled in Medicare?

Yes. Ivon Waters is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ivon Waters was last updated on July 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.