Healthcare Provider Details

I. General information

NPI: 1982674099
Provider Name (Legal Business Name): SUZANNE L. WATKINS L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NORTHPOINTE CIR SUITE 306
SEVEN FIELDS PA
16046-7851
US

IV. Provider business mailing address

100 NORTHPOINTE CIR STE 306
SEVEN FIELDS PA
16046-7851
US

V. Phone/Fax

Practice location:
  • Phone: 724-772-4848
  • Fax: 724-772-4888
Mailing address:
  • Phone: 724-772-4848
  • Fax: 724-772-4888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018045
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: