Provider Demographics
NPI:1780433847
Name:WATKINS, LILLIAN V (LCSW)
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:V
Last Name:WATKINS
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 1:20 FORTY ACRES DR
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-2702
Mailing Address - Country:US
Mailing Address - Phone:508-314-2249
Mailing Address - Fax:
Practice Address - Street 1:20 FORTY ACRES DR
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-2702
Practice Address - Country:US
Practice Address - Phone:508-314-2249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW230550104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker