THEODORE ANTHONY WATSON LADC NPI 1104981968

NPI Information

  • NPI: 1104981968
  • Provider Name: THEODORE ANTHONY WATSON, LADC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 1941 S 42ND ST
    STE 540
    OMAHA, NE
    ZIP 68105
  • Phone: (402) 558-2034

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NPI Details

Theodore Anthony Watson, LADC is an addiction (substance use disorder) counselor in Omaha, NE. Theodore Anthony Watson, LADC NPI is 1104981968. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1941 S 42ND ST
STE 540
OMAHA, NE
ZIP 68105-939
Phone: (402) 558-2034
Fax: (402) 614-1540

The enumeration date for this NPI number is 12/22/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)150NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
126MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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