Provider Demographics
NPI:1750425435
Name:WATKINS, RICHARD O II (MSW LMSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:O
Last Name:WATKINS
Suffix:II
Gender:M
Credentials:MSW LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3462 MILLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48746-9608
Mailing Address - Country:US
Mailing Address - Phone:989-239-5850
Mailing Address - Fax:
Practice Address - Street 1:8361 ELLIS RD
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:MI
Practice Address - Zip Code:48746-0359
Practice Address - Country:US
Practice Address - Phone:989-871-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801071148101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2205038382066Medicare ID - Type Unspecified