Provider Demographics
NPI:1346491412
Name:WATSON, LAURIE JANE (LMFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:JANE
Last Name:WATSON
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:LOVING
Other - Middle Name:AND LIVING
Other - Last Name:CENTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT, LPC
Mailing Address - Street 1:9205 BAILEYWICK RD STE 200
Mailing Address - Street 2:LOVING AND LIVING CENTER, PC
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1977
Mailing Address - Country:US
Mailing Address - Phone:919-845-5400
Mailing Address - Fax:919-854-5431
Practice Address - Street 1:9205 BAILEYWICK RD STE 200
Practice Address - Street 2:LOVING AND LIVING CENTER, PC
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-1977
Practice Address - Country:US
Practice Address - Phone:919-845-5400
Practice Address - Fax:919-854-5431
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC758106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC460489059OtherEIN