MEDICARE: MRS. SHEWAYN WATSON 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	1041C0700X	Clinical Social Worker	114394	TX
2	1041C0700X	Clinical Social Worker	5192	LA
3	1041C0700X	Clinical Social Worker	149.029518	IL
4	1041C0700X	Clinical Social Worker	LC200003371	DC

General Provider Information

NPI Number	:	1942669668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEWAYN WATSON LCSW

Provider Business Mailing Address
First Line	:	1819 WEDGWOOD DR
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-7428
Country	:	US
Telephone Number	:	504-237-7429
Fax Number	:	504-302-9649

Provider Business Practice Location Address
First Line	:	1819 WEDGWOOD DR STE E
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-7428
Country	:	US
Telephone Number	:	504-237-7429
Fax Number	:	504-302-9649

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

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	03/20/2026

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