Active NPI
Kristen Shannon Watford, LCMHC
- Professional Counselor
- Washington, NC
National Provider Identifier
1588317580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A17199
- Practice address
- 607 Washington St.
Washington, NC 27892 - Phone
- (252) 792-8035
- NPI assigned
- Jan 31, 2022
- Last updated
- Jan 31, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A17199 | NC | Primary |
Addresses
Primary practice location
607 Washington St.
Washington, NC 27892
Mailing address
116 Chowan Shores Dr
Colerain, NC 27924-9320
Phone (252) 267-8445
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
| License | State | Type | Specialty |
|---|---|---|---|
| A17199 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643587200000",
"number": "1588317580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 CHOWAN SHORES DR",
"city": "COLERAIN",
"state": "NC",
"postal_code": "279249320",
"telephone_number": "252-267-8445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 WASHINGTON ST.",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "27892",
"telephone_number": "252-792-8035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATFORD",
"first_name": "KRISTEN",
"middle_name": "SHANNON",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-31",
"last_updated": "2022-01-31",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A17199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.