MEDICARE: ALMA WATKINS LMHC, CASAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	17933	NY
2	101YM0800X	Mental Health Counselor	001447	NY

General Provider Information

NPI Number	:	1235521899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALMA WATKINS LMHC, CASAC

Provider Business Mailing Address
First Line	:	300 HAYWARD AVE
Second Line	:	4H
City	:	FLEETWOOD
State	:	NY
Zip	:	10552-1718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 HAYWARD AVE
Second Line	:	4H
City	:	FLEETWOOD
State	:	NY
Zip	:	10552-1718
Country	:	US
Telephone Number	:	646-234-1632
Fax Number	:

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

Provider Enumeration Date	:	02/19/2015
Last Update Date	:	02/19/2015

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