Healthcare Provider Details

I. General information

NPI: 1023945250
Provider Name (Legal Business Name): EMILY LADD LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 SHERIDAN BLVD UNIT C192
EDGEWATER CO
80214-1313
US

IV. Provider business mailing address

225 E 4TH AVE
DURANGO CO
81301-5717
US

V. Phone/Fax

Practice location:
  • Phone: 443-944-3557
  • Fax:
Mailing address:
  • Phone: 443-944-3557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW.0009925536
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: