Kelle A Watson, MA LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701005236 Issued in VA

Practice address

780 Lynnhaven Pkwy Ste 110
Virginia Beach, VA 23452-7351

Phone

(757) 301-8747

NPI assigned

Nov 8, 2005

Last updated

Nov 4, 2024By the provider in NPPES

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

Other identifiers 1

Other names 1

• Kelle Audrey Watson Other name

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

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Commonwealth Counseling Associates Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805

  Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1164403085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY STE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527351",
            "telephone_number": "757-301-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY STE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527351",
            "telephone_number": "757-301-8747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Lynnhaven Pkwy Ste 340",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234527361",
            "country_code": "US",
            "telephone_number": "757-301-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KELLE",
        "middle_name": "A",
        "credential": "MA  LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005236",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701005236",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015758110002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLE",
            "last_name": "WATSON",
            "middle_name": "AUDREY",
            "credential": "MA  LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Watson, NP-C
• Essence Latrice Watson, PHARMD
• James Christopher Watson Jr.
• Jennifer Rose Watson, M.P.T.
• Katelyn Watson, PA-S
• Lisa Ervin Watson, CCC-SLP
• Monet Domonique Watson
• Nicole Monique Watson, FNP-BC
• Sherri Rae Watson
• Toni Watson

• Professional Counselor in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.
• 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.