Provider Demographics
NPI:1861706921
Name:WATKINS, JANICE BEATRICE (EDD, LPC)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:BEATRICE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 SOUTH LEWIS AVENUE, STE 190
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105
Mailing Address - Country:US
Mailing Address - Phone:918-404-5357
Mailing Address - Fax:918-742-7677
Practice Address - Street 1:4870 SOUTH LEWIS AVENUE, STE 190
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105
Practice Address - Country:US
Practice Address - Phone:918-404-5357
Practice Address - Fax:918-742-7677
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-01
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK551101YP2500X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional