Provider Demographics
NPI:1376695890
Name:WATTS-MEANS, SONJA (MSW)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:WATTS-MEANS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14626 MAIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3026
Mailing Address - Country:US
Mailing Address - Phone:240-644-2580
Mailing Address - Fax:
Practice Address - Street 1:14626 MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3026
Practice Address - Country:US
Practice Address - Phone:301-952-0600
Practice Address - Fax:301-952-1303
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD087951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD021536B35Medicare PIN