Provider Demographics
NPI:1790204790
Name:WATKINS, LORI (LISW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 US 50
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-8694
Mailing Address - Country:US
Mailing Address - Phone:513-732-5033
Mailing Address - Fax:
Practice Address - Street 1:2040 US 50
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-8694
Practice Address - Country:US
Practice Address - Phone:513-732-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1600074104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker