Provider Demographics
NPI:1912280272
Name:WATTS-KUMAR, SERENA (LPC)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:WATTS-KUMAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 GARDENDALE ST
Mailing Address - Street 2:BLDG 601
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3475
Mailing Address - Country:US
Mailing Address - Phone:210-558-0409
Mailing Address - Fax:
Practice Address - Street 1:4230 GARDENDALE ST
Practice Address - Street 2:BLDG 601
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3475
Practice Address - Country:US
Practice Address - Phone:210-558-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health