Provider Demographics
NPI:1548517741
Name:LOUIDOR, WATSON W (LMHC)
Entity type:Individual
Prefix:MR
First Name:WATSON
Middle Name:W
Last Name:LOUIDOR
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1320 NE 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3115
Mailing Address - Country:US
Mailing Address - Phone:352-505-2840
Mailing Address - Fax:352-464-6330
Practice Address - Street 1:4131 NW 13TH ST STE 206
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-1863
Practice Address - Country:US
Practice Address - Phone:352-505-2840
Practice Address - Fax:352-464-6330
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC# 10638101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health