Glen Watson, CASAC-T

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

764 E 176TH St
Bronx, NY 10460-4606

Phone

(718) 542-8770

NPI assigned

Jul 8, 2022

Sex

Male

Sole proprietor

No

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)

Not enrolled

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1174256911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 HERKIMER ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112336129",
            "telephone_number": "347-358-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 E 176TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604606",
            "telephone_number": "718-542-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "GLEN",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chely Watson-Badell
• Esther Denise Carline Watson-Douglas
• Ahiela Laquira Watson
• Candace Monisha Watson
• Chase Matthew Watson
• Kimberly Watson
• Kimberly Charytina Watson, M.D.
• Nicole Watson
• Randy Watson
• Ruddisha Watson

• Addiction (Substance Use Disorder) Counselor in Bronx, NY
• Providers in Bronx, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.