MEDICARE: MS. SHAKIERA WATSON LMSW

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	123091	NY

General Provider Information

NPI Number	:	1861248452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAKIERA WATSON LMSW

Provider Business Mailing Address
First Line	:	145 STANTON ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-1623
Country	:	US
Telephone Number	:	917-723-2047
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 STANTON ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-1623
Country	:	US
Telephone Number	:	917-723-2047
Fax Number	:

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

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	01/12/2026

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