Kenmar Watterson, CPRS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

APS.004566 Issued in OH

Practice address

4145 Chelsea Square Ave
Columbus, OH 43230-4454

Phone

(513) 462-1079

NPI assigned

Mar 29, 2024

Last updated

Mar 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

• 479 Watt

  • Community/Behavioral Health Agency
  • Cincinnati, OH
  • NPI 1508701616
  NPD Authorized official

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1285485086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4145 CHELSEA SQUARE AVE APT 108",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432304446",
            "telephone_number": "513-462-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4145 CHELSEA SQUARE AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432304454",
            "telephone_number": "513-462-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERSON",
        "first_name": "KENMAR",
        "credential": "CPRS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "APS.004566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Joan Watt, DO
• Padet Wattanasarn, M.D.
• Amanda M Wattenberg, MFT-S
• Corey Michael Watters Sr.
• Margaret L Watters
• Seth Watterson
• Allan Wattimena, DDS
• Agatha Rebecca Watts
• Alysha Gwen Watts
• Amanda J Watts, LISW

• Addiction (Substance Use Disorder) Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.