Provider Demographics
NPI:1730398736
Name:WATJEN, MARYANN BETH (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:MARYANN
Middle Name:BETH
Last Name:WATJEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WHISPER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1859
Mailing Address - Country:US
Mailing Address - Phone:828-243-1773
Mailing Address - Fax:
Practice Address - Street 1:16 WHISPER CREEK LN
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1859
Practice Address - Country:US
Practice Address - Phone:828-243-1773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0012921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002818Medicaid
NC85961OtherBCBSNC