Provider Demographics
NPI:1871273581
Name:WATTS, KATHERINE ANNE (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANNE
Last Name:WATTS
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5632 EBLEY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-0629
Mailing Address - Country:US
Mailing Address - Phone:336-972-7189
Mailing Address - Fax:
Practice Address - Street 1:3703 LATROBE DR STE 240
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1364
Practice Address - Country:US
Practice Address - Phone:252-573-2200
Practice Address - Fax:252-373-2044
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0194251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical