Provider Demographics
NPI:1710449582
Name:WATSON, PATRICIA GARRISON (LMSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GARRISON
Last Name:WATSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 SAINT CHARLES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4830
Mailing Address - Country:US
Mailing Address - Phone:504-579-4179
Mailing Address - Fax:504-891-1172
Practice Address - Street 1:1615 POYDRAS ST STE 900
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-1282
Practice Address - Country:US
Practice Address - Phone:504-259-7642
Practice Address - Fax:504-891-1172
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6392101YP2500X, 1041C0700X, 171M00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator