MEDICARE: STEPHANIE JEAN WATSON-DRAYTON 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	CW026841	PA

General Provider Information

NPI Number	:	1760731442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE JEAN WATSON-DRAYTON LCSW

Provider Business Mailing Address
First Line	:	1180 E DORSET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19150-3117
Country	:	US
Telephone Number	:	215-868-4321
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 E DORSET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19150-3117
Country	:	US
Telephone Number	:	215-868-4321
Fax Number	:

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

Provider Enumeration Date	:	09/10/2012
Last Update Date	:	12/17/2025

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