Healthcare Provider Details

I. General information

NPI: 1588938237
Provider Name (Legal Business Name): AHMEIN WATSON LCSW-C, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2012
Last Update Date: 10/03/2023
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PINE HEIGHTS AVE STE 303
BALTIMORE MD
21229-5202
US

IV. Provider business mailing address

1001 PINE HEIGHTS AVE STE 303
BALTIMORE MD
21229-5202
US

V. Phone/Fax

Practice location:
  • Phone: 443-219-7901
  • Fax: 443-835-2521
Mailing address:
  • Phone: 443-722-3116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16481
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number16481
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: