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NPI Code Detail

MEDICARE: MICHAEL WATTERSON PSY.D.

MEDICARE: MICHAEL WATTERSON PSY.D.
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
1103T00000XPsychologistPS018295PA
2101YP2500XProfessional CounselorPC007568PA

General Provider Information

NPI Number : 1891176889
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL WATTERSON PSY.D.
Provider Business Mailing Address
First Line : 205 S DUFFY RD
Second Line : STE B
City : BUTLER
State : PA
Zip : 16001-2789
Country : US
Telephone Number : 724-256-9881
Fax Number : 724-256-9883
Provider Business Practice Location Address
First Line : 205 S DUFFY RD
Second Line : STE B
City : BUTLER
State : PA
Zip : 16001-2789
Country : US
Telephone Number : 724-256-9881
Fax Number : 724-256-9883
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2015
Last Update Date : 04/11/2025

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