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General NPI Number Information
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NPI Number | 1770455719
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Entity Type | Organization
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Legal Business Name | DR. LISA WATSON, PSYCHOLOGIST, INC.
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 163 BEACH 96TH ST # 2B
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1304
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Country | US
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Telephone | 858-898-1855
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Fax | 858-898-1890
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Provider Business Mailing Address
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Address Line | 16004 CROSSBAY BLVD # 163
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City | HOWARD BEACH
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State | NY
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Zip | 11414-3407
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Country | US
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Telephone | 858-898-1855
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Fax | 858-898-1890
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA M WATSON
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Credential | PHD
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Telephone | 917-497-1744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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