Provider Demographics
NPI:1740878362
Name:WATLINGTON, PATRICIA SHAVAWN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:SHAVAWN
Last Name:WATLINGTON
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 1:2906 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-4063
Mailing Address - Country:US
Mailing Address - Phone:432-202-3067
Mailing Address - Fax:
Practice Address - Street 1:1501 W 11TH PL STE 104
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-4122
Practice Address - Country:US
Practice Address - Phone:432-263-0027
Practice Address - Fax:432-264-3297
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130576104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker