Provider Demographics
NPI:1134666472
Name:WATKINS, MEREDITH L (LPC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:L
Last Name:WATKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:L
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19282 SONORA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-7973
Mailing Address - Country:US
Mailing Address - Phone:479-409-1170
Mailing Address - Fax:479-750-4843
Practice Address - Street 1:60 W SUNBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1822
Practice Address - Country:US
Practice Address - Phone:479-695-1240
Practice Address - Fax:479-750-4843
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1910159101YM0800X
171M00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator