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Individual

HEATHER WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1255 S MICHIGAN AVE APT 3105, CHICAGO, IL 60605-3318
(919) 215-2674
Mailing address
1255 S MICHIGAN AVE APT 3105, CHICAGO, IL 60605-3318

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
149019788
IL
251B00000X
Case Management Agency
252Y00000X
Early Intervention Provider Agency
261QC1500X
Community Health Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center
261QS1000X
Student Health Clinic/Center
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/27/2020
Last updated
12/19/2025
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