| Nick Watters, Psyd Plc | |
|
240 W Dixie Ave Suite 5-b Elizabethtown KY 42701-1586 | |
| (270) 401-4107 | |
| Not Available |
| Full Name | Nick Watters, Psyd Plc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 240 W Dixie Ave, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Nicholas Watters (CEO) |
| Authorized Official Contact | 2704014107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nick Watters, Psyd Plc Po Box 6278 Elizabethtown KY 42702-6278 Ph: (270) 401-4107 | Nick Watters, Psyd Plc 240 W Dixie Ave Suite 5-b Elizabethtown KY 42701-1586 Ph: (270) 401-4107 |
| NPI Number | 1801136361 |
|---|---|
| Provider Enumeration Date | 02/20/2013 |
| Last Update Date | 07/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801136361 | NPI | - | NPPES |
| 30605018 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | KY-1492 (Kentucky) | Primary |
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