Provider Demographics
NPI:1073204772
Name:WATSON, DANICA (LCSW, LCDC)
Entity Type:Individual
Prefix:MS
First Name:DANICA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6517 BLUE GRASS DR
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-1704
Mailing Address - Country:US
Mailing Address - Phone:682-472-7980
Mailing Address - Fax:
Practice Address - Street 1:6517 BLUE GRASS DR
Practice Address - Street 2:
Practice Address - City:WATAUGA
Practice Address - State:TX
Practice Address - Zip Code:76148-1704
Practice Address - Country:US
Practice Address - Phone:682-472-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX682081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical