Demetric Watkins, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH21916 Issued in FL

Practice address

7901 4TH St N Ste 300
St Petersburg, FL 33702-4399

Phone

(813) 501-3124

Fax

(813) 492-2195

NPI assigned

May 2, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Serenity Xcelled Counseling LLC

  • Mental Health Counselor
  • St Petersburg, FL
  • NPI 1588307805
  NPD Authorized official

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

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1891316667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7037 SPOTTED DEER PL",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335788977",
            "telephone_number": "813-501-3124",
            "fax_number": "813-492-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024399",
            "telephone_number": "813-501-3124",
            "fax_number": "813-492-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "DEMETRIC",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-02",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@serenityxcelledcounseling.com",
            "affiliation": "N",
            "endpointDescription": "General Correspondence",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7901 4th St N Ste 300",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337024399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Kennedy Waterman, M.A. CCC SLP
• Kathryn M Waterman, RPA-C, MPAS
• Waters Edge Medical Clinic Tampa LLC
• Michele Waters Suro
• Alexis Waters Waters
• Floyd L. Watkins
• Scott Christopher Watkins, MD
• Cynthia Anice Watson, M.S. C.G.G.
• Shidelle Watson, APRN, PMHNP-BC
• Maya Watts

• Mental Health Counselor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.