Healthcare Provider Details

I. General information

NPI: 1649099581
Provider Name (Legal Business Name): JENNIFER LAUREN WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER BOWENS MSW, LSW

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3517 HIGH HILL RD
EFFORT PA
18330-7712
US

IV. Provider business mailing address

3517 HIGH HILL RD
EFFORT PA
18330-7712
US

V. Phone/Fax

Practice location:
  • Phone: 484-634-0319
  • Fax:
Mailing address:
  • Phone: 484-634-0319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06619300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW027695
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: