Elizabeth Watt Psy D LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60609307 Issued in WA

Legal business name

ELIZABETH WATT PSY D LLC

Practice address

1140 10TH St Ste 211
Bellingham, WA 98225-7053

Phone

(630) 363-1472

Fax

(844) 621-7037

NPI assigned

Aug 9, 2018

Organization subpart

No

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

Authorized official

Name

Sherri Lewis

Title

Billing Manager

Phone

(360) 441-9515

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1821577933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 10TH ST STE 211",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257053",
            "telephone_number": "630-363-1472",
            "fax_number": "844-621-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 10TH ST STE 211",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257053",
            "telephone_number": "630-363-1472",
            "fax_number": "844-621-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH WATT PSY D LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "360-441-9515"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60609307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2059830",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David Elkayam, MD
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• Joann Marie Elkins
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• Clinical Psychologist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.