Provider Demographics
NPI:1770106510
Name:WELLS, EMMETT JOSEPH (LCSW)
Entity type:Individual
Prefix:
First Name:EMMETT
Middle Name:JOSEPH
Last Name:WELLS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5100
Mailing Address - Country:US
Mailing Address - Phone:720-670-6504
Mailing Address - Fax:
Practice Address - Street 1:8420 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5100
Practice Address - Country:US
Practice Address - Phone:720-670-6504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099265851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty