Provider Demographics
NPI:1164069142
Name:WATSON, EMILY KREWSON (LCMHC, LCAS, NCC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KREWSON
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCMHC, LCAS, NCC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:SCOTT
Other - Last Name:KREWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 S MARSHALL ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2843
Mailing Address - Country:US
Mailing Address - Phone:336-594-0400
Mailing Address - Fax:
Practice Address - Street 1:100 S MARSHALL ST STE 1
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2843
Practice Address - Country:US
Practice Address - Phone:336-594-0400
Practice Address - Fax:336-276-1516
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25296101YA0400X
NC14984101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)