Jennifer Dattilo Watts

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0717001579 Issued in VA

Practice address

2206 Executive Dr Ste a
Hampton, VA 23666-2583

Phone

(757) 597-8350

NPI assigned

Oct 3, 2019

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

Enrolled in VA

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

Specialty

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Strengthen & Empower Neurofeedback Services, LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newport News, VA
  • NPI 1013764455
  Medicare reassignment NPD Authorized official
• Fly Family Therapy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newport News, VA
  • NPI 1881171668
  Medicare reassignment NPD
• Foundations to Success, LLC

  • Community/Behavioral Health Agency
  • Newport News, VA
  • NPI 1538887898
  NPD (past)

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1124669858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LONG BRIDGE RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236692021",
            "telephone_number": "757-813-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 EXECUTIVE DR STE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662583",
            "telephone_number": "757-597-8350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 J Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011540",
            "country_code": "US",
            "telephone_number": "757-597-8350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATTILO WATTS",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathryn Collins Darcy, LMSW
• Ahmed Dardeir, MD
• Dare to Empower Residential Services LLC
• Darlene Sykes
• Matthew Daroja, PT
• Yash Dave
• William L Davenport, D.D.S.
• David'S Hope House, LLC
• James Ryan Davidson, LPC
• John Barry Davidson Jr., M.D.

• Marriage & Family Therapist in Hampton, VA
• Providers in Hampton, VA by specialty
• Marriage & Family Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.