Individual provider Active NPI

Ena May Watson, PH.D., BCD, LCSW-C

  • Clinical Social Worker
  • Camp Springs, MD
National Provider Identifier
1225216401
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5625 Allentown Rd
Suite 102
Camp Springs, MD 20746-4521
Phone
(301) 899-2497
Fax
(301) 899-2499
NPI assigned
Feb 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

5625 Allentown Rd
Suite 102
Camp Springs, MD 20746-4521

Mailing address

5625 Allentown Rd
Suite 102
Camp Springs, MD 20746-4521
Phone (301) 899-2497

Other identifiers 1

IdentifierTypeStateIssuer
116721900MedicaidMD

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05193MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1202515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1225216401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 ALLENTOWN RD",
            "address_2": "SUITE 102",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207464521",
            "telephone_number": "301-899-2497",
            "fax_number": "301-899-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 ALLENTOWN RD",
            "address_2": "SUITE 102",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207464521",
            "telephone_number": "301-899-2497",
            "fax_number": "301-899-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ENA",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCD, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-09",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116721900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Springs, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.