Provider Demographics
NPI:1821790585
Name:WATSON, CHERISE KIMBERLY (LMHC-QS)
Entity Type:Individual
Prefix:
First Name:CHERISE
Middle Name:KIMBERLY
Last Name:WATSON
Suffix:
Gender:F
Credentials:LMHC-QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 972542
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33197-2542
Mailing Address - Country:US
Mailing Address - Phone:305-528-1352
Mailing Address - Fax:
Practice Address - Street 1:24324 SW 113TH PASS
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-7109
Practice Address - Country:US
Practice Address - Phone:305-528-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health