Provider Demographics
NPI:1154646362
Name:WATKINS, MARCUS DAYON (LPC, LCAS-A)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:DAYON
Last Name:WATKINS
Suffix:
Gender:M
Credentials:LPC, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1464
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-7464
Mailing Address - Country:US
Mailing Address - Phone:252-541-3517
Mailing Address - Fax:252-541-3088
Practice Address - Street 1:608 JACKSON ST STE 209
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-2600
Practice Address - Country:US
Practice Address - Phone:252-541-3517
Practice Address - Fax:252-541-3088
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7823101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health