Provider Demographics
NPI:1386111615
Name:WATSON, EMMA JANE (LCISW)
Entity type:Individual
Prefix:MS
First Name:EMMA
Middle Name:JANE
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5214
Mailing Address - Country:US
Mailing Address - Phone:360-329-2055
Mailing Address - Fax:
Practice Address - Street 1:315 LAKEWAY DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5214
Practice Address - Country:US
Practice Address - Phone:360-329-2055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW609213001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical