Cory D Watson, LCSW
Individual provider Active NPI Clinical Social Worker · Whiteman Afb, MO
NPI 1891179115 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1891179115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2015016528 (MO)
- Practice address
- 331 Sijen Ave
Whiteman Afb, MO 65305-1269 - Phone
- (660) 687-4341
- NPI assigned
- Jul 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015016528 | MO | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2015016528 | MO | Yes |
Addresses
Primary practice location
331 Sijen Ave
Whiteman Afb, MO 65305-1269
Mailing address
331 Sijen Ave BLDG 2032
Whiteman Afb, MO 65305-1269
Phone (660) 687-7332
Other names
- Mr. Cory Watson
Other providers in Whiteman Afb, MO
- Jennifer Lee Unkel
- Matthew Scot Van Uitert
- Tosha Vann
- Kristopher M.G. Wagner-Porter
- Amia R Watson
- Glenda M Wilcox
- William Arthur Winslow II
- Rebecca Gail Yasunaga
- David Andrew Yosick
- Carlos X Zambrano
All providers in Whiteman Afb, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.