Provider Demographics
NPI:1952707366
Name:WATTS, KATHERINE (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WATTS
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 1:50 MOODY ST
Mailing Address - Street 2:SWEETSER
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1536
Mailing Address - Country:US
Mailing Address - Phone:800-434-3000
Mailing Address - Fax:
Practice Address - Street 1:5 BRAGDON LN STE 1
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7262
Practice Address - Country:US
Practice Address - Phone:207-337-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC164321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical