Active NPI
Jonathan Bernard Watts, CDCA
- Addiction (Substance Use Disorder) Counselor
- Massillon, OH
National Provider Identifier
1689321895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.177845
- Practice address
- 2520 Wales Ave NW
Massillon, OH 44646-2398 - Phone
- (234) 348-3869
- NPI assigned
- Mar 8, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.177845 | OH | Primary |
Addresses
Primary practice location
2520 Wales Ave NW
Massillon, OH 44646-2398
Mailing address
111 Eaton Ridge Dr Apt 312
Northfield, OH 44067-1565
Phone (330) 696-0693
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 |
|---|---|---|---|
| CDCA.177845 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646697600000",
"number": "1689321895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 EATON RIDGE DR APT 312",
"city": "NORTHFIELD",
"state": "OH",
"postal_code": "440671565",
"telephone_number": "330-696-0693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 WALES AVE NW",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446462398",
"telephone_number": "234-348-3869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "JONATHAN",
"middle_name": "BERNARD",
"name_prefix": "Mr.",
"credential": "CDCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-08",
"last_updated": "2022-03-08",
"certification_date": "2022-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.177845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.