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General NPI Number Information
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NPI Number | 1477922490
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Entity Type | Individual
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Provider Name | KRISTI WATSON M.S LCADC, CCTP, BIP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2015
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 1000 E JOHN ROWAN BLVD STE 107
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City | BARDSTOWN
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State | KY
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Zip | 40004
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Country | US
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Telephone | 502-331-6002
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Fax | 502-331-6122
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Provider Business Mailing Address
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Address Line | 89 INDIAN SPRINGS TRCE
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City | SHELBYVILLE
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State | KY
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Zip | 40065-8359
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Country | US
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Telephone | 502-827-9797
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ADCADC00223243
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 167170
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License Number State | KY
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