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

Ryan Watters, LSW

Individual provider Clinical Social Worker · NPI 1174255103

Ryan Watters, LSW is a Clinical Social Worker in Chicago, Illinois. Qualified in 2022, 4 years ago. Practices with Tides Mental Health of Il, PLLC, a 3-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

1 E Superior St Ste 306
Chicago, IL 60611-2595
Phone: (312) 754-9404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1174255103
Entity typeIndividual (Type 1)
GenderMale
Credentials LSW
Sole proprietorNo
NPI enumeratedJune 28, 2022
Last updated in NPPESJune 28, 2022
Certification dateJune 28, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Tides Mental Health Of Il, Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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