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NPI Code Detail

MEDICARE: MELINDA WATSON

MEDICARE:   MELINDA  WATSON
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 Worker6801096891MI

General Provider Information

NPI Number : 1477485860
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINDA WATSON
Provider Business Mailing Address
First Line : 1603 FERRY ST
Second Line :
City : NILES
State : MI
Zip : 49120-2052
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1030 MINERS RD STE C
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-9709
Country : US
Telephone Number : 269-235-9083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ MELINDA WATSON ” Practice Location

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