Provider Demographics
NPI:1154689396
Name:WATSON, KEVIN CURTIS (LPC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:CURTIS
Last Name:WATSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ORLAND SQUARE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-6523
Mailing Address - Country:US
Mailing Address - Phone:708-364-7046
Mailing Address - Fax:708-364-7048
Practice Address - Street 1:60 ORLAND SQUARE DR STE 203
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6523
Practice Address - Country:US
Practice Address - Phone:708-364-7046
Practice Address - Fax:708-364-7048
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.003729101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor