Provider Demographics
NPI:1013241215
Name:WATTS LCSW & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WATTS LCSW & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALONZO
Authorized Official - Middle Name:FRITZGERALD
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:III
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-410-4966
Mailing Address - Street 1:60 CONNOLLY PKWY BUILDING 2B
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-2593
Mailing Address - Country:US
Mailing Address - Phone:203-909-6705
Mailing Address - Fax:475-238-6355
Practice Address - Street 1:60 CONNOLLY PKWY
Practice Address - Street 2:BUILDING 2C SUITE 206
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2593
Practice Address - Country:US
Practice Address - Phone:203-909-6705
Practice Address - Fax:203-909-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0068451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty