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General NPI Number Information
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NPI Number | 1538508353
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Entity Type | Individual
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Provider Name | JAN L WATKINS LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 505 WYTHE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1917
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Country | US
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Telephone | 571-305-2320
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Fax |
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Provider Business Mailing Address
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Address Line | 407 N LEE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2301
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Country | US
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Telephone | 703-408-0091
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50079206
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007670
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License Number State | VA
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