Provider Demographics
NPI:1710299631
Name:WATSON, SHERRI L (MSW, LADC(US))
Entity Type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:L
Last Name:WATSON
Suffix:
Gender:F
Credentials:MSW, LADC(US)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S INDEPENDENCE ST
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-4043
Mailing Address - Country:US
Mailing Address - Phone:918-697-5163
Mailing Address - Fax:
Practice Address - Street 1:519 S INDEPENDENCE ST
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4043
Practice Address - Country:US
Practice Address - Phone:918-697-5163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker