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NPI Code Detail

MEDICARE: LISA BERNARD-WATTS

MEDICARE:   LISA  BERNARD-WATTS
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
1101YP2500XProfessional CounselorCTB-2026-0124NM

General Provider Information

NPI Number : 1083488712
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA BERNARD-WATTS
Provider Business Mailing Address
First Line : PO BOX 3141
Second Line :
City : CARLSBAD
State : NM
Zip : 88221-3141
Country : US
Telephone Number : 575-725-5552
Fax Number :
Provider Business Practice Location Address
First Line : 1900 WESTRIDGE RD
Second Line :
City : CARLSBAD
State : NM
Zip : 88220-3550
Country : US
Telephone Number : 575-725-5552
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2023
Last Update Date : 02/11/2026

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Directions to “ LISA BERNARD-WATTS ” Practice Location

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