Provider Demographics
NPI:1699132092
Name:S. EILEEN WATTERS, LPCC-S
Entity type:Organization
Organization Name:S. EILEEN WATTERS, LPCC-S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL CLINICAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:WATTERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:740-225-5342
Mailing Address - Street 1:21 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1911
Mailing Address - Country:US
Mailing Address - Phone:740-225-5342
Mailing Address - Fax:855-217-5840
Practice Address - Street 1:21 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1911
Practice Address - Country:US
Practice Address - Phone:740-225-5342
Practice Address - Fax:855-217-5840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003580251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management