Provider Demographics
NPI:1093948788
Name:WATKINS, FAITH (LCSW)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:SPAULDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3565 S STATE ROAD 13
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-9162
Mailing Address - Country:US
Mailing Address - Phone:260-563-8453
Mailing Address - Fax:260-569-0335
Practice Address - Street 1:3565 S STATE ROAD 13
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-9162
Practice Address - Country:US
Practice Address - Phone:260-563-8453
Practice Address - Fax:260-569-0335
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005743A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN292440Medicare Oscar/Certification