Provider Demographics
NPI:1801252085
Name:WATSON, KASHAWNA (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KASHAWNA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 GIRARD ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3427
Mailing Address - Country:US
Mailing Address - Phone:202-367-1762
Mailing Address - Fax:
Practice Address - Street 1:1017 GIRARD ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3427
Practice Address - Country:US
Practice Address - Phone:202-367-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500799141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical