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General NPI Number Information
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NPI Number | 1427006949
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Entity Type | Individual
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Provider Name | JOSEPH B. WATTERSON LISW-CP
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2611 LIBERTY HILL RD SWCMHC/KERSHAW CMHC
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City | CAMDEN
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State | SC
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Zip | 29020-1871
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Country | US
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Telephone | 803-432-5323
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Fax | 803-713-3978
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Provider Business Mailing Address
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Address Line | 215 N MAGNOLIA ST SWCMHC
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City | SUMTER
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State | SC
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Zip | 29150-4943
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Country | US
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Telephone | 803-775-9364
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Fax | 803-773-6615
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 002108
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License Number State | SC
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