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General NPI Number Information
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NPI Number | 1578162574
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Entity Type | Individual
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Provider Name | ADRIANE DENISE WATTERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 101 S JENNINGS AVE STE 104
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City | FORT WORTH
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State | TX
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Zip | 76104-1112
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Country | US
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Telephone | 682-250-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 17350 STATE HIGHWAY 249 STE 220
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City | HOUSTON
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State | TX
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Zip | 77064-1132
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Country | US
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Telephone | 817-723-2713
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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 | 60589
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License Number State | TX
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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 | 60589
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 60589
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License Number State | TX
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