Healthcare Provider Details

I. General information

NPI: 1154802122
Provider Name (Legal Business Name): DENEEN WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14337 EUCLID AVE
CLEVELAND OH
44112-3401
US

IV. Provider business mailing address

9406 BOHNING DR
GARFIELD HTS OH
44125-1433
US

V. Phone/Fax

Practice location:
  • Phone: 216-284-3255
  • Fax:
Mailing address:
  • Phone: 216-804-6942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.2303776
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.189385
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: