Healthcare Provider Details

I. General information

NPI: 1174399398
Provider Name (Legal Business Name): COURTNEY BETH WATKINS MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COURTNEY BETH JONES

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N RIDGE RD
ELYRIA OH
44035-1241
US

IV. Provider business mailing address

2100 N RIDGE RD
ELYRIA OH
44035-1241
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-1300
  • Fax: 440-277-0409
Mailing address:
  • Phone: 440-324-1300
  • Fax: 440-277-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2608275
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: