Provider Demographics
NPI:1366165441
Name:WATTS, LEAH REBECCA (LMFTA)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:REBECCA
Last Name:WATTS
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-1394
Mailing Address - Country:US
Mailing Address - Phone:423-641-1491
Mailing Address - Fax:
Practice Address - Street 1:2005 FLINT LN
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3334
Practice Address - Country:US
Practice Address - Phone:423-641-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12456A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist