Lisa Watson, MDIV

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

5407 Excelsior Blvd
Suite B
St Louis Park, MN 55416-2929

Phone

(612) 483-4994

NPI assigned

Sep 20, 2016

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 MN

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 1

Specialty

Marriage and Family Therapist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West End Therapy Clinic LLCGroup PAC ID 7113361916, 9 clinicians

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 and National Provider Directory roles.

• West End Therapy Clinic LLC

  • Marriage & Family Therapist
  • St Louis Park, MN
  • NPI 1407332547
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1407304314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 EXCELSIOR BLVD",
            "address_2": "SUITE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162929",
            "telephone_number": "612-483-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5407 EXCELSIOR BLVD",
            "address_2": "SUITE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162929",
            "telephone_number": "612-483-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LISA",
        "credential": "MDIV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Bernice Wasz, CRNA
• Anne Portilla Watkins, M.D.
• Michael D Watkins, FNP-C
• Angela Watson
• Daniel Watson
• Rao Fu Watson, M.D.
• Charles Reginald Watts, M.D.
• Loretta Wearmouth
• Michelle Christine Weaver
• Kevin Robert Webb-Kay, MD

• Marriage & Family Therapist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.