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NPI Code Detail

MEDICARE: LISA WATSON

MEDICARE: LISA WATSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker4487HI
21041C0700XClinical Social Worker60992547WA
31041C0700XClinical Social Worker09925885CO

General Provider Information

NPI Number : 1457700312
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA WATSON
Provider Business Mailing Address
First Line : 250 FILLMORE ST UNIT 150
Second Line :
City : DENVER
State : CO
Zip : 80206-5001
Country : US
Telephone Number : 887-258-0288
Fax Number :
Provider Business Practice Location Address
First Line : 250 FILLMORE ST UNIT 150
Second Line :
City : DENVER
State : CO
Zip : 80206-5001
Country : US
Telephone Number : 887-258-0288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2016
Last Update Date : 09/07/2025

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