Provider Demographics
NPI:1124727441
Name:WATSON, TRICIA LYNN (MA, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:LYNN
Last Name:WATSON
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-4366
Mailing Address - Country:US
Mailing Address - Phone:682-282-5850
Mailing Address - Fax:
Practice Address - Street 1:300 S MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4366
Practice Address - Country:US
Practice Address - Phone:682-282-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90256101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional