Individual
JESSE WATERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1011 N CHARLES ST, BALTIMORE, MD 21201-5424
(443) 971-1451
Mailing address
5613 WINTHROPE AVE, BALTIMORE, MD 21214-2754
(443) 707-5558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
24653
MD
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
04/25/2021
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