Jennifer McDermott Watley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW11105 Issued in FL

Practice address

2738 Jon Bull St
Flagler Beach, FL 32136-6102

Phone

(386) 503-8445

NPI assigned

Jul 23, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1306221007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2738 JON BULL ST",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321366102",
            "telephone_number": "386-503-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2738 JON BULL ST",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321366102",
            "telephone_number": "386-503-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATLEY",
        "first_name": "JENNIFER",
        "middle_name": "MCDERMOTT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Tipton, RCSWI
• Charles Traubert, R.PH.
• Patricia Kay Turbyfill, ARNP
• Lisa Waite
• Shelby Walker, OTR/L
• Whispering Meadows Ranch
• Winner Healthcare LLC
• Rebecca Pauline Wiseman, RN
• James Matthew Zaenglein, MD

• Clinical Social Worker in Flagler Beach, FL
• Providers in Flagler Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.