Healthcare Provider Details

I. General information

NPI: 1083165054
Provider Name (Legal Business Name): NAKIA T WATSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 WOODSIDE CT STE 100-1011
COLUMBIA MD
21046-1017
US

IV. Provider business mailing address

1717 N ST NW STE 1
WASHINGTON DC
20036-2827
US

V. Phone/Fax

Practice location:
  • Phone: 646-926-4682
  • Fax:
Mailing address:
  • Phone: 646-926-4682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number092396
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30276
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC014732
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC2000002077
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: