Provider Demographics
NPI:1881099505
Name:WATTS, SARAH (STUDENT)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:STUDENT
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ELLEN
Other - Last Name:WISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 MARCELLA ST # 1R
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1216
Mailing Address - Country:US
Mailing Address - Phone:617-445-1849
Mailing Address - Fax:
Practice Address - Street 1:77 WARREN ST
Practice Address - Street 2:BRIGHTON ALLSTON MENTAL HEALTH ASSOCIATION
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3601
Practice Address - Country:US
Practice Address - Phone:617-787-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health