Provider Demographics
NPI:1275286916
Name:AMY GRASSI WATSON, PC
Entity Type:Organization
Organization Name:AMY GRASSI WATSON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:GRASSI
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMHCS
Authorized Official - Phone:252-245-1876
Mailing Address - Street 1:4213 BRITTHILL LN
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8146
Mailing Address - Country:US
Mailing Address - Phone:252-245-1876
Mailing Address - Fax:
Practice Address - Street 1:4003 NASH ST NW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1130
Practice Address - Country:US
Practice Address - Phone:252-640-2493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty