Healthcare Provider Details

I. General information

NPI: 1174458525
Provider Name (Legal Business Name): EMILY RAE WATSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY RAE STOCKDALE LCSW

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8931 HURON ST
THORNTON CO
80260-6806
US

IV. Provider business mailing address

338 COLONY PL
LONGMONT CO
80501-3414
US

V. Phone/Fax

Practice location:
  • Phone: 303-853-3500
  • Fax:
Mailing address:
  • Phone: 720-467-8664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW.09933342
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933342
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: