Provider Demographics
NPI:1942639992
Name:WATTS, KERRI (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6371 PRESTON RD STE 120
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7979
Mailing Address - Country:US
Mailing Address - Phone:215-799-0517
Mailing Address - Fax:214-594-8458
Practice Address - Street 1:6371 PRESTON RD STE 120
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:215-799-0517
Practice Address - Fax:214-594-8458
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-09
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69163101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional