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NPI Code Detail

MEDICARE: MAGGIE WATTS MSW, LCSWA

MEDICARE: MAGGIE WATTS MSW, LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP021106NC

General Provider Information

NPI Number : 1063215820
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGGIE WATTS MSW, LCSWA
Provider Business Mailing Address
First Line : 500 E DAVIE ST STE 140
Second Line :
City : RALEIGH
State : NC
Zip : 27601-2093
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1735 GUESS RD
Second Line :
City : DURHAM
State : NC
Zip : 27701-1163
Country : US
Telephone Number : 919-514-3566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2025
Last Update Date : 03/28/2025

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