Individual
WENDI WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS, CADC
Contact information
Practice address
3826 BLAND RD, RALEIGH, NC 27609-6239
(919) 872-1441
(919) 872-1455
Mailing address
402 W FRANKLIN ST, ZEBULON, NC 27597
(919) 986-4130
(919) 872-1441
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23849
NC
1041C0700X
Clinical Social Worker
P011733
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902210784
—
NC
Enumeration date
06/19/2014
Last updated
03/17/2020
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