Provider Demographics
NPI:1881166676
Name:WATSON, JENNIFER MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:THOCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:511A E WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-1229
Mailing Address - Country:US
Mailing Address - Phone:703-517-7549
Mailing Address - Fax:
Practice Address - Street 1:1436 U ST NW STE 303
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3988
Practice Address - Country:US
Practice Address - Phone:202-529-5261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040105271041C0700X
DCLC500824411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical