Active NPI
Kathy Boyette-Watson, LCSW
- Social Worker
- Hampton, VA
National Provider Identifier
1619256997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 0904007603
- Practice address
- 600 Medical Dr
Suite a & B
Hampton, VA 23666-1769 - Phone
- (757) 788-0600
- Fax
- (757) 788-0932
- NPI assigned
- Aug 4, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 0904007603 | VA | Primary |
Addresses
Primary practice location
600 Medical Dr
Suite a & B
Hampton, VA 23666-1769
Mailing address
300 Medical Dr
2ND Floor
Hampton, VA 23666-1765
Phone (757) 788-0092
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904007603 | VA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334016000000",
"number": "1619256997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MEDICAL DR",
"address_2": "2ND FLOOR",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236661765",
"telephone_number": "757-788-0092",
"fax_number": "757-788-0969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 MEDICAL DR",
"address_2": "SUITE A & B",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236661769",
"telephone_number": "757-788-0600",
"fax_number": "757-788-0932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYETTE-WATSON",
"first_name": "KATHY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-04",
"last_updated": "2012-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "VA",
"license": "0904007603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.