Provider Demographics
NPI:1700699014
Name:WATSON, VALENTINE OLIVER II
Entity type:Individual
Prefix:
First Name:VALENTINE
Middle Name:OLIVER
Last Name:WATSON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16A CIRCUIT ST
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1925
Mailing Address - Country:US
Mailing Address - Phone:617-895-8521
Mailing Address - Fax:
Practice Address - Street 1:1 UNION ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-2408
Practice Address - Country:US
Practice Address - Phone:781-515-0167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health