Provider Demographics
NPI:1013174671
Name:WATSON, HILARY LYSSA (LCSWC)
Entity Type:Individual
Prefix:MS
First Name:HILARY
Middle Name:LYSSA
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 WHITE OAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4159
Mailing Address - Country:US
Mailing Address - Phone:443-985-0541
Mailing Address - Fax:410-588-5898
Practice Address - Street 1:8003 CORPORATE DRIVE
Practice Address - Street 2:SUITE G
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-931-0990
Practice Address - Fax:410-931-2144
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD138341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical