Provider Demographics
NPI:1225197155
Name:WATKINS PHD, JANE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:WATKINS PHD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RICE MINE ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUSCALCOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406
Mailing Address - Country:US
Mailing Address - Phone:205-758-1995
Mailing Address - Fax:205-758-1995
Practice Address - Street 1:150 RICE MINE ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:TUSCALCOSA
Practice Address - State:AL
Practice Address - Zip Code:35406
Practice Address - Country:US
Practice Address - Phone:205-758-1995
Practice Address - Fax:205-758-1995
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL796101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0602Medicare UPIN