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General NPI Number Information
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NPI Number | 1699132092
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Entity Type | Organization
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Legal Business Name | S. EILEEN WATTERS, LPCC-S
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 21 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1911
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Country | US
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Telephone | 740-225-5342
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Fax | 855-217-5840
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Provider Business Mailing Address
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Address Line | 21 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1911
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Country | US
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Telephone | 740-225-5342
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Fax | 855-217-5840
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Authorized Official
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Title or Position | PROFESSIONAL CLINICAL COUNSELOR
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Name | MS. SHARON EILEEN WATTERS
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Credential | LPCC-S
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Telephone | 740-225-5342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | E0003580
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License Number State | OH
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