Individual provider Active NPI

Chantell Watson

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1710474168
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103041-1 Issued in NY
Practice address
2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990
Phone
(212) 633-9300
NPI assigned
Apr 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 103041-1 NY Primary

Addresses

Primary practice location

2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990

Mailing address

590 Avenue of Americas
New York, NY 10011-9904

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

LicenseStateTypeSpecialty
103041-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1710474168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 AVENUE OF AMERICAS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 ADAM CLAYTON POWELL JR BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274990",
            "telephone_number": "212-633-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "CHANTELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "103041-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.