Individual provider Active NPI

Mary Monica Watkins-Clay, PH.D.

  • Clinical Psychologist
  • Marianna, FL
National Provider Identifier
1376708388
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7150 Issued in FL
Practice address
4970 Highway 90
Marianna, FL 32446-6802
Phone
(850) 718-5620
Fax
(850) 718-5670
NPI assigned
Jul 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X
Clinical Psychologist 103TC0700X PY7150 FL Primary

Addresses

Primary practice location

4970 Highway 90
Marianna, FL 32446-6802

Mailing address

4970 Highway 90
Marianna, FL 32446-6802
Phone (850) 718-5620

Other names 1

  • Dr. Mary Monica Watkins Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY7150FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1376708388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4970 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466802",
            "telephone_number": "850-718-5620",
            "fax_number": "850-718-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4970 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466802",
            "telephone_number": "850-718-5620",
            "fax_number": "850-718-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS-CLAY",
        "first_name": "MARY",
        "middle_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-20",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WATKINS",
            "middle_name": "MONICA",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.