Provider Demographics
NPI:1922600584
Name:WATSON, KATLYN (LLMSW)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:DURAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 S WEST ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2543
Mailing Address - Country:US
Mailing Address - Phone:517-214-1733
Mailing Address - Fax:
Practice Address - Street 1:411 S WEST ST
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2543
Practice Address - Country:US
Practice Address - Phone:517-214-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical