Provider Demographics
NPI:1205118346
Name:EMERY, CECILIA RENEE (LCSW)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:RENEE
Last Name:EMERY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S WILCOX ST # 2191
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-9997
Mailing Address - Country:US
Mailing Address - Phone:661-622-3545
Mailing Address - Fax:661-793-6520
Practice Address - Street 1:220 S WILCOX ST # 2191
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-9997
Practice Address - Country:US
Practice Address - Phone:661-622-3545
Practice Address - Fax:661-793-6520
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX527491041C0700X
CO099282991041C0700X
CA670391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA67039OtherLCSW FROM CALIFORNIA BOARD OF BEHAVIORAL SCIENCES
CO09928299OtherCOLORADO LCSW
TX52749OtherTX LICENSE