Judith Watta, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904009896

Practice address

21 N Broad St Ste E # 10104
Luray, VA 22835-1162

Phone

(571) 449-7837

Fax

(571) 449-7837

NPI assigned

Jun 13, 2017

Last updated

Jul 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in VA, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Look Inside Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Luray, VA
  • NPI 1760116297

  MI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1356871305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 806054",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480806054",
            "telephone_number": "571-449-7837",
            "fax_number": "571-449-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N BROAD ST STE E # 10104",
            "city": "LURAY",
            "state": "VA",
            "postal_code": "228351162",
            "telephone_number": "571-449-7837",
            "fax_number": "571-449-7837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22725 Greater Mack Ave Ste B301",
            "address_2": "Unit 321",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480802048",
            "country_code": "US",
            "telephone_number": "703-402-2218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTA",
        "first_name": "JUDITH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "0904009896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Therapies, Inc (Excel Therapy)
• Ruben Antonio Villeda, M.D.
• Virginia CVS Pharmacy LLC (CVS Pharmacy # 07593)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2564)
• Cheyanne Waters, PA-C
• Arthur Webb, M.D.
• Werner Ernst Wiedemann, D.D.S.
• Jennifer Yealy, PA-C

• Clinical Social Worker in Luray, VA
• Providers in Luray, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.