Provider Demographics
NPI:1346515582
Name:WATSON, ASHLEY ELYSE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ELYSE
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 E PUTNAM AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4877
Mailing Address - Country:US
Mailing Address - Phone:203-273-4405
Mailing Address - Fax:
Practice Address - Street 1:523 E PUTNAM AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4877
Practice Address - Country:US
Practice Address - Phone:203-273-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0078141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical