Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Living Waters Medical Center

Organization Addiction (Substance Use Disorder) Counselor · NPI 1114585619

Living Waters Medical Center is an Addiction (Substance Use Disorder) Counselor in Logan, West Virginia. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2

Practice location Address checks out

100 Main Ave
Logan, WV 25601-3323
Phone: (304) 946-8350
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1114585619
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amber Ellis — Director/Family Nurse Practitioner · (304) 946-8350
NPI enumeratedMay 31, 2019
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025
Mailing address100 Main Ave, Logan, WV 25601-3323

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