Active NPI
Sherry Lorraine Watson, CDP
- Addiction (Substance Use Disorder) Counselor
- Tumwater, WA
National Provider Identifier
1174995153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP 00002667
- Practice address
- 1550 Irving St SW Ste 301
Tumwater, WA 98512-6362 - Phone
- (360) 870-9252
- NPI assigned
- Oct 29, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP 00002667 | WA | Primary |
Addresses
Primary practice location
1550 Irving St SW Ste 301
Tumwater, WA 98512-6362
Mailing address
1550 Irving St SW Ste 301
Tumwater, WA 98512-6362
Phone (360) 870-9252
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2077844 | Medicaid | WA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP 00002667 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1174995153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 IRVING ST SW STE 301",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985126362",
"telephone_number": "360-870-9252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 IRVING ST SW STE 301",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985126362",
"telephone_number": "360-870-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "SHERRY",
"middle_name": "LORRAINE",
"name_prefix": "Ms.",
"credential": "CDP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-29",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP 00002667",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2077844",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.