MEDICARE: AHMEIN WATSON LCSW-C, LCADC

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	1041S0200X	School Social Worker	16481
2	1041C0700X	Clinical Social Worker	16481	MD

General Provider Information

NPI Number	:	1588938237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMEIN WATSON LCSW-C, LCADC

Provider Business Mailing Address
First Line	:	1001 PINE HEIGHTS AVE STE 303
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21229-5202
Country	:	US
Telephone Number	:	443-722-3116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 PINE HEIGHTS AVE STE 303
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21229-5202
Country	:	US
Telephone Number	:	443-219-7901
Fax Number	:	443-835-2521

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

Provider Enumeration Date	:	02/28/2012
Last Update Date	:	10/03/2023

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