MEDICARE: MRS. PATRICIA SHAVAWN WATLINGTON LCSW

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	104100000X	Social Worker	130576	TX
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1740878362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA SHAVAWN WATLINGTON LCSW

Provider Business Mailing Address
First Line	:	2906 W 13TH ST
Second Line	:
City	:	BIG SPRING
State	:	TX
Zip	:	79720-4063
Country	:	US
Telephone Number	:	432-202-3067
Fax Number	:

Provider Business Practice Location Address
First Line	:	2906 W 13TH ST
Second Line	:
City	:	BIG SPRING
State	:	TX
Zip	:	79720-4063
Country	:	US
Telephone Number	:	432-202-3067
Fax Number	:

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

Provider Enumeration Date	:	01/08/2021
Last Update Date	:	05/19/2025

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