Provider Demographics
NPI:1548486533
Name:WATKINS, CARLOS F (LCSW)
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:F
Last Name:WATKINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6528 HOLLINGSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5006
Mailing Address - Country:US
Mailing Address - Phone:317-216-0379
Mailing Address - Fax:
Practice Address - Street 1:3333 FOUNDERS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-4933
Practice Address - Country:US
Practice Address - Phone:317-872-1749
Practice Address - Fax:317-872-1756
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002793A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical