Healthcare Provider Details

I. General information

NPI: 1952509721
Provider Name (Legal Business Name): CYNTHIA JOHNSON WATSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 EAST ST STE 1001-F7
PITTSBORO NC
27312-9711
US

IV. Provider business mailing address

216 STILLHOUSE FARM DR
GRAHAM NC
27253-3386
US

V. Phone/Fax

Practice location:
  • Phone: 919-704-8449
  • Fax:
Mailing address:
  • Phone: 919-302-7441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC001916
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC001916
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC001916
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberC001916
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: