MEDICARE: ASHLEY NICOLE WATSON MS, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2017044139	MO

General Provider Information

NPI Number	:	1023525110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NICOLE WATSON MS, LPC

Provider Business Mailing Address
First Line	:	1503 S 3RD ST
Second Line	:
City	:	OZARK
State	:	MO
Zip	:	65721-9189
Country	:	US
Telephone Number	:	417-543-2494
Fax Number	:

Provider Business Practice Location Address
First Line	:	1503 S 3RD ST
Second Line	:
City	:	OZARK
State	:	MO
Zip	:	65721-9189
Country	:	US
Telephone Number	:	417-543-2494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2018
Last Update Date	:	01/20/2026

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