Active NPI
Julie Watts, LICSW
- Psychologist
- Boston, MA
National Provider Identifier
1114066347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 104703
- Practice address
- 877 Beacon St
Boston, MA 02215 - Phone
- (617) 262-5845
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 104703 | MA | Primary |
| Psychologist | 103T00000X | 190 | NH |
Addresses
Primary practice location
877 Beacon St
Boston, MA 02215
Mailing address
877 Beacon St
Boston, MA 02215
Phone (617) 262-5845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WAP02868 | Other | MA | BLUE CROSS BLUE SHIELD |
Other names 1
- Julie Watts Lutch
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190 | NH | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114066347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "877 BEACON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02215",
"telephone_number": "617-262-5845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 BEACON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02215",
"telephone_number": "617-262-5845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "JULIE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "104703",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NH",
"license": "190",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "WAP02868",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JULIE",
"last_name": "LUTCH",
"middle_name": "WATTS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.