Provider Demographics
NPI:1972498152
Name:WATSON, CATINA DIANE (LPN, THERAPIST)
Entity type:Individual
Prefix:
First Name:CATINA
Middle Name:DIANE
Last Name:WATSON
Suffix:
Gender:F
Credentials:LPN, THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5733 CLEMENS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-2607
Mailing Address - Country:US
Mailing Address - Phone:314-497-4150
Mailing Address - Fax:
Practice Address - Street 1:5733 CLEMENS AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2607
Practice Address - Country:US
Practice Address - Phone:314-497-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 101YA0400X, 101YM0800X, 101YP1600X, 103TA0700X, 101YS0200X, 103TB0200X, 106H00000X, 171400000X, 171M00000X, 173C00000X, 174H00000X, 374J00000X
MO101Y00000X
MO2001033439164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No173C00000XOther Service ProvidersReflexologist
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula