Provider Demographics
NPI:1588044465
Name:WATSON, MATTHEW (MS, LPC, NCC, PLMFT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:MS, LPC, NCC, PLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8237 OAK ST
Mailing Address - Street 2:STUDIO B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8237 OAK ST
Practice Address - Street 2:STUDIO B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-2041
Practice Address - Country:US
Practice Address - Phone:504-229-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health