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Individual
KATHLEEN WATANABE
Active
Individual
KATHLEEN WATANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00039
CT
1041C0700X
Clinical Social Worker
004228
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140004228CT01
ANTHEM
CT
Enumeration date
09/01/2006
Last updated
09/11/2025
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