Provider Demographics
NPI:1255385936
Name:WATSON, FIONA J (LCSW)
Entity type:Individual
Prefix:MS
First Name:FIONA
Middle Name:J
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PENN PLAZA
Mailing Address - Street 2:SUITE 727
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1820
Mailing Address - Country:US
Mailing Address - Phone:917-415-3724
Mailing Address - Fax:
Practice Address - Street 1:16 PENN PLAZA
Practice Address - Street 2:SUITE 727
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1820
Practice Address - Country:US
Practice Address - Phone:917-415-3724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03949411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3571868OtherOXFORD
NY02006320Medicaid
NY02006320Medicaid