Jimena Amanda Watts, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P015501 Issued in NC

Practice address

133 Stetson Dr
Charlotte, NC 28262-3326

Phone

(704) 770-7814

NPI assigned

Sep 14, 2021

Last updated

Sep 14, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Camino Community Development Corporation

  dba Bethesda Health Center

  • Primary Care Clinic/Center
  • Charlotte, NC
  • NPI 1588984348
  NPD (past)

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1215607171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 EAST BLVD UNIT 302",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035978",
            "telephone_number": "704-770-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 STETSON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623326",
            "telephone_number": "704-770-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "JIMENA",
        "middle_name": "AMANDA",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jimena@camino.org",
            "affiliation": "Y",
            "affiliationName": "Camino Health Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "133 Stetson Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282623326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Watt, DNP, PMHNP-BC
• John Michael Wattenbarger, MD
• Alea Watts
• Alyssa May Watts
• Jaclyn Deta Watts, BSN, RN
• Katherine Anne Watts, MSW, LCSWA
• Kayla Louise Watts, MSPO, CPO
• Larica Watts
• Larry T. Watts, MD
• Latasha Denise Watts, LCSW

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.