Watters, Nicholas
Watters, Nicholas is an individual health care provider with primary practice located at 240 W Dixie, Suite 5-B, Elizabethtown KY 42701-1575. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Watters, Nicholas can be contacted via phone (270) 401-4107.Contact Information
Primary practice address
240 W Dixie, Suite 5-B
Elizabethtown KY 42701-1575
Phone: (270) 401-4107
Fax: (270) 209-0872
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1492 | Kentucky |
Profile Details
| NPI number | 1063468817 |
|---|---|
| LBN Legal business name | Watters, Nicholas |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | May 31st, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063468817 | NPPES |
| Other | 11574941 | CAQH | |
| MEDICAID | 7100266120 | CAQH |
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