Shirley Joan Watkins, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2010030790 Issued in MO

Practice address

108 W Jasper St
Versailles, MO 65084-1020

Phone

(573) 378-6833

Fax

(573) 378-6823

NPI assigned

Sep 27, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Benton Street Counseling LLC

  • Professional Counselor
  • Rolla, MO
  • NPI 1578053955
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1013226943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W JASPER ST",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841020",
            "telephone_number": "573-378-6833",
            "fax_number": "573-378-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W JASPER ST",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841020",
            "telephone_number": "573-378-6833",
            "fax_number": "573-378-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "SHIRLEY",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2010030790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Teschner
• Ivette C Turner, M.D.
• Versailles Hearing LLC
• Nicole Taylor Vogt
• Wal-Mart Stores East LP
• Savannah Rose Westermier, MS, CF-SLP
• Lanna Jane Whisler, SLP
• Sarah Jane Whiston, MS, CF-SLP
• Lana L Whitehead, MS, LPC

• Clinical Psychologist in Versailles, MO
• Providers in Versailles, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.