Provider Demographics
NPI:1992426787
Name:WATSON PSYCHIATRY LLC
Entity type:Organization
Organization Name:WATSON PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:AMY
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:720-773-4771
Mailing Address - Street 1:6979 S HOLLY CIR STE 215
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1423
Mailing Address - Country:US
Mailing Address - Phone:720-773-4771
Mailing Address - Fax:720-414-1530
Practice Address - Street 1:6979 S HOLLY CIR STE 215
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1423
Practice Address - Country:US
Practice Address - Phone:720-773-4771
Practice Address - Fax:720-414-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty