Active NPI
Emily Watson
- Social Worker
- Normal, IL
National Provider Identifier
1609640390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.112459
- Practice address
- 405 N Kays Dr Ste C
Normal, IL 61761-1979 - Phone
- (309) 807-5077
- Fax
- (309) 214-9679
- NPI assigned
- Nov 13, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.112459 | IL | Primary |
Addresses
Primary practice location
405 N Kays Dr Ste C
Normal, IL 61761-1979
Mailing address
405 N Kays Dr Ste C
Normal, IL 61761-1979
Phone (309) 822-2991
Other names 1
- Mrs. Emily Watson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.112459 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1609640390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 N KAYS DR STE C",
"city": "NORMAL",
"state": "IL",
"postal_code": "617611979",
"telephone_number": "309-822-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 N KAYS DR STE C",
"city": "NORMAL",
"state": "IL",
"postal_code": "617611979",
"telephone_number": "309-807-5077",
"fax_number": "309-214-9679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "EMILY",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-13",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.112459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "WATSON",
"prefix": "MRS.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.