Provider Demographics
NPI:1558746842
Name:WATSON, ANDREW (MS, LMHC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N MILLS AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5746
Mailing Address - Country:US
Mailing Address - Phone:407-259-4286
Mailing Address - Fax:
Practice Address - Street 1:430 N MILLS AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803
Practice Address - Country:US
Practice Address - Phone:407-259-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH13555101YM0800X
FLMH15664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health