Provider Demographics
NPI:1740564970
Name:WATKINS, ANITA Z (LMSW)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:Z
Last Name:WATKINS
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 1:32 WESTMINSTER PARK
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9723
Mailing Address - Country:US
Mailing Address - Phone:585-427-7388
Mailing Address - Fax:
Practice Address - Street 1:32 WESTMINSTER PARK
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9723
Practice Address - Country:US
Practice Address - Phone:585-427-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04478211041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool