Healthcare Provider Details

I. General information

NPI: 1508568205
Provider Name (Legal Business Name): ROBIN ELIZABETH WATTS MA, LPC/MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 TRIANGLE PARK DR
MARYVILLE TN
37801-3749
US

IV. Provider business mailing address

1706 TRIANGLE PARK DR
MARYVILLE TN
37801-3749
US

V. Phone/Fax

Practice location:
  • Phone: 865-900-9507
  • Fax:
Mailing address:
  • Phone: 865-900-9507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6009
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: