Provider Demographics
NPI:1154739860
Name:BRADSHAW WATTS, ANNE ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:BRADSHAW WATTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:ELIZABETH
Other - Last Name:BRADHSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 791
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443
Mailing Address - Country:US
Mailing Address - Phone:970-485-5202
Mailing Address - Fax:
Practice Address - Street 1:721 GRANITE ST.
Practice Address - Street 2:SUITE 206
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-485-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW099230121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical