Individual provider Active NPI

Damian Wesley Watson, LCSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1295132918
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12081 Issued in FL
Practice address
12041 Tuscany Bay Dr
Apt. 101
Tampa, FL 33626-1339
Phone
(850) 889-6476
Fax
(850) 889-6476
NPI assigned
Nov 24, 2014
Last updated
Nov 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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 SW12081 FL Primary

Addresses

Primary practice location

12041 Tuscany Bay Dr
Apt. 101
Tampa, FL 33626-1339

Mailing address

12041 Tuscany Bay Dr
Apt. 101
Tampa, FL 33626-1339
Phone (850) 889-6476

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

State licenses

LicenseStateTypeSpecialty
SW12081FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1295132918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12041 TUSCANY BAY DR",
            "address_2": "APT. 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261339",
            "telephone_number": "850-889-6476",
            "fax_number": "850-889-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12041 TUSCANY BAY DR",
            "address_2": "APT. 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261339",
            "telephone_number": "850-889-6476",
            "fax_number": "850-889-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DAMIAN",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.