Healthcare Provider Details

I. General information

NPI: 1245472596
Provider Name (Legal Business Name): DANIEL WATKINS LMFT, LPC, MAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 07/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 BULL ST SUITE 216
SAVANNAH GA
31405-2016
US

IV. Provider business mailing address

1939 BEECH ST
SAVANNAH GA
31404-1301
US

V. Phone/Fax

Practice location:
  • Phone: 912-596-6449
  • Fax: 888-444-8435
Mailing address:
  • Phone: 912-596-6449
  • Fax: 888-444-8435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC005474
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT001160
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: