MEDICARE: MISS REBECCA ANN WATSON MS, QP, NCC, LPC

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
1	101YP2500X	Professional Counselor	5413	NC
2	101YM0800X	Mental Health Counselor	009588	NY

General Provider Information

NPI Number	:	1992893994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS REBECCA ANN WATSON MS, QP, NCC, LPC

Provider Business Mailing Address
First Line	:	8842 AVEBURY DR
Second Line	:	APT M
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-3119
Country	:	US
Telephone Number	:	704-661-8070
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 HARDING PL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2921
Country	:	US
Telephone Number	:	704-962-5342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	02/03/2025

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