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General NPI Number Information
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NPI Number | 1518386044
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Entity Type | Individual
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Provider Name | TIFFANY WATSON LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/11/2014
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 105 HAMILTON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-1610
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Country | US
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Telephone | 718-924-2618
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Fax | 718-448-1959
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Provider Business Mailing Address
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Address Line | 117 WEST 124TH STREET 6TH FLOOR BILLING DEPT
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City | NEW YORK
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State | NY
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Zip | 10027
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Country | US
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Telephone | 212-949-4878
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Fax | 212-681-6315
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 007031
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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