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Provider Information for 1780321968


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JESSICA ANGELA WATKINS LCSW


Sex: Female

NPI: 1780321968
Last Updated: 2022-05-31
Certification Date: 2022-05-31

Details

NameValue
NPI1780321968
Enumeration Date2022-05-18
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 588 BURGUNDY M
DELRAY BEACH, FL 33484-4918
United States

Phone: 561-213-4103 | Fax:
 
Primary Practice Address 588 BURGUNDY M
DELRAY BEACH, FL 33484-4918
United States

Phone: 561-213-4103 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)FLSW20033Therapy
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - Clinical