Provider Demographics
NPI:1770819849
Name:WATSON, AMY GRASSI (MS, LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:GRASSI
Last Name:WATSON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 BRITTHILL LN
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8146
Mailing Address - Country:US
Mailing Address - Phone:252-291-9835
Mailing Address - Fax:
Practice Address - Street 1:4213 BRITTHILL LN
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8146
Practice Address - Country:US
Practice Address - Phone:252-291-9835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7588101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health