Provider Demographics
NPI:1275710808
Name:WATT, KAY CLEMMONS (MAPC,LPC)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:CLEMMONS
Last Name:WATT
Suffix:
Gender:F
Credentials:MAPC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 BUSBY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1116
Mailing Address - Country:US
Mailing Address - Phone:210-826-7447
Mailing Address - Fax:210-826-7440
Practice Address - Street 1:515 BUSBY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1116
Practice Address - Country:US
Practice Address - Phone:210-826-7447
Practice Address - Fax:210-826-7440
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health