Demetruis Renee Watson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

258957 Issued in KY

Practice address

1412 N Broadway Ste 204
Lexington, KY 40505-3157

Phone

(859) 412-1445

NPI assigned

Dec 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kentucky Services, LLC

  • Marriage & Family Therapist
  • Lexington, KY
  • NPI 1609448059
  Medicare reassignment NPD
• Northern Kentucky Mental Health Mental Retardation Regional Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Covington, KY
  • NPI 1578527610
  Medicare reassignment NPD
• Victory House LLC

  • Mental Health Counselor
  • Lexington, KY
  • NPI 1033898853

  Clinical

  Medicare reassignment NPD
• First Choice Solutions LLC

  • Professional Counselor
  • Lexington, KY
  • NPI 1346855590

  Clinical

  NPD
• Kentucky Services, LLC

  • Primary Care Nurse Practitioner
  • Lexington, KY
  • NPI 1811602832
  NPD
• Northern Kentucky Mental Health Mental Retardation Regional Board

  • Psychiatric Hospital
  • Covington, KY
  • NPI 1679775514
  NPD

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1013252071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 LYNHAVEN DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274067105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 N BROADWAY STE 204",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405053157",
            "telephone_number": "859-412-1445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Farrell Dr",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410113717",
            "country_code": "US",
            "telephone_number": "859-578-3200",
            "fax_number": "859-534-2627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2031 Martin Luther King Jr Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274063342",
            "country_code": "US",
            "telephone_number": "336-271-5888",
            "fax_number": "336-271-5882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DEMETRUIS",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P006989",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "258957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regan Taylor Watkins, PHARMD/MBA
• Samantha Nicole Watkins
• Savannah Renee Watkins
• Shelby Jeneise Watkins
• Darren Alex Watson, CRNA
• Laura Watson, M.D.
• Mary Elizabeth Watson, PA
• Samuel Jacob Watson, M.D.
• Bethany Cooper Watt, M.S.
• Grant Watt, CRNA

• Clinical Social Worker in Lexington, KY
• Providers in Lexington, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.