Individual provider Active NPI

Ian Cole Watts, LCSW

  • Clinical Social Worker
  • Lubbock, TX
National Provider Identifier
1295254571
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
63469 Issued in TX
Practice address
4413 71St St Ste G101
Lubbock, TX 79424-2319
Phone
(806) 412-4721
Fax
(806) 500-2935
NPI assigned
Sep 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8479 OK
Clinical Social Worker 1041C0700X 63469 TX Primary

Addresses

Primary practice location

4413 71St St Ste G101
Lubbock, TX 79424-2319

Mailing address

3513 50TH St
Lubbock, TX 79413-4003
Phone (806) 438-8089

Other practice location 1

3513 50th St
Lubbock, TX 79413-4003
Phone (806) 438-8089

Other practice location 2

700 N Robinson Dr
Robinson, TX 76706-5050
Phone (254) 251-3414 ext. 705

Other practice location 3

4101 N Classen Blvd Ste D
Oklahoma City, OK 73118-2413
Phone (405) 261-3223 ext. 705

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

LicenseStateTypeSpecialty
63469TXMDProfessional Counselor
8479OKMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mental Health Associates PLLC Clinical CurrentSince Dec 17, 2023 Accepting new patients
SWMH Services LLC Current Accepting new patients
Stages of Recovery, Inc Past Accepting new patients

Locations

4413 71st St
Ste G101
Lubbock, TX 79424
Phone (254) 495-2139

3513 50th St
Lubbock, TX 79413
Phone (806) 412-4721

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1295254571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 50TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794134003",
            "telephone_number": "806-438-8089",
            "fax_number": "806-500-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 71ST ST STE G101",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242319",
            "telephone_number": "806-412-4721",
            "fax_number": "806-500-2935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3513 50th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794134003",
            "country_code": "US",
            "telephone_number": "806-438-8089",
            "fax_number": "806-500-2935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 N Robinson Dr",
            "address_purpose": "LOCATION",
            "city": "Robinson",
            "state": "TX",
            "postal_code": "767065050",
            "country_code": "US",
            "telephone_number": "254-251-3414 x705",
            "fax_number": "806-500-2935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4101 N Classen Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731182413",
            "country_code": "US",
            "telephone_number": "405-261-3223 x705",
            "fax_number": "806-500-2935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "IAN",
        "middle_name": "COLE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "8479",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.