Individual
MICHELE GREEN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
LGP3628
MD
101YP2500X
Professional Counselor
Primary
LC4641
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609500300
—
MD
05
—
609500303
—
MD
05
—
609550001
—
MD
05
—
609550002
—
MD
05
—
609550004
—
MD
Enumeration date
10/28/2009
Last updated
09/27/2012
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