Paul Bradley Watts, LPC, CSOTP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5913 Issued in TN

Practice address

162D Market Place Blvd
Knoxville, TN 37922-2337

Phone

(865) 212-6600

Fax

(865) 313-2149

NPI assigned

Mar 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tennessee Valley TMS, LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Knoxville, TN
  • NPI 1649889130
  NPD
• Bearden Behavioral Health, LLC

  • Exclusive Provider Organization
  • Knoxville, TN
  • NPI 1700223773
  NPD (past)

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1649739863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31569",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379301569",
            "telephone_number": "865-212-6600",
            "fax_number": "865-313-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162D MARKET PLACE BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222337",
            "telephone_number": "865-212-6600",
            "fax_number": "865-313-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "PAUL",
        "middle_name": "BRADLEY",
        "credential": "LPC, CSOTP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701008229",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701008229",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raven Cyndre'a Watson
• Ronda Erin Watson, BA, RAS, LADAC
• Sabrina Watson, HS
• William Doster Watson, MD, PHD
• Jacob Watts, DPT
• Rachel Watts
• Vickie Ames Watts, RDH
• Mary Katsikas Waugh, COUNSELOR
• Wave Wellness
• David Way

• Professional Counselor in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.