Provider Demographics
NPI:1790232353
Name:CHARITA WATKINS
Entity Type:Organization
Organization Name:CHARITA WATKINS
Other - Org Name:THREATT COUNSELING AND BEHAVIORAL HEALTH SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THREATT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-318-9601
Mailing Address - Street 1:10107 KRAUSE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6506
Mailing Address - Country:US
Mailing Address - Phone:804-318-9601
Mailing Address - Fax:804-318-9876
Practice Address - Street 1:10107 KRAUSE ROAD SUITE 100
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23838
Practice Address - Country:US
Practice Address - Phone:804-318-9601
Practice Address - Fax:804-318-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006556251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health