Provider Demographics
NPI:1720231624
Name:WATSON, REGINA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 COMPRESS RD
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-1125
Mailing Address - Country:US
Mailing Address - Phone:504-450-0334
Mailing Address - Fax:
Practice Address - Street 1:312 COURT ST
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-5248
Practice Address - Country:US
Practice Address - Phone:337-363-5525
Practice Address - Fax:337-363-1567
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical