Provider Demographics
NPI:1902384043
Name:WATTS, DEANNA A (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:A
Last Name:WATTS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8548 WESTFIELD PARK DR
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1791
Mailing Address - Country:US
Mailing Address - Phone:440-382-9949
Mailing Address - Fax:
Practice Address - Street 1:11565 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3356
Practice Address - Country:US
Practice Address - Phone:440-846-0862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.18021581041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool