Provider Demographics
NPI:1407382724
Name:WATSON, STACEY-ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:STACEY-ANN
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:STACEY-ANN
Other - Middle Name:
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 LOCUST HILL AVE
Mailing Address - Street 2:C/O MARTIN LUTHER KING JR ELEMENTARY SCHOOL WJCS PG
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-2917
Mailing Address - Country:US
Mailing Address - Phone:914-376-8174
Mailing Address - Fax:914-376-3715
Practice Address - Street 1:135 LOCUST HILL AVE
Practice Address - Street 2:C/O MARTIN LUTHER KING JR ELEMENTARY SCHOOL WJCS PG
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-2917
Practice Address - Country:US
Practice Address - Phone:914-376-8174
Practice Address - Fax:914-376-3715
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093644104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker