| Doctor Name: | MS. AVERY ANISE WATSON |
| NPI Number: | 1467871079 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BSW, MSW, LCAS-A |
| License Number: | 20099 |
| Business Practice Address: | 2301 Rama Rd Suit B Charlotte, NC - 282126237 |
| Business Phone Number: | 8608886058 |
| Business Fax Number: | 7045683353 |
| Mailing Address: | 5307 Firelight Ln Unit G, CHARLOTTE |
| State: | NC |
| Postal Code: | 282122210 |
| Phone Number: | 8608886058 |
| Fax Number: | 7045633353 |
| NPI Enumeration Date: | 04/10/2014 |
| NPI Last Update Date: | 04/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 20099 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |