MEDICARE: TERESE ELIZABETH WILLIAMS LCSW

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
1	1041C0700X	Clinical Social Worker	09925282	CO

General Provider Information

NPI Number	:	1588226773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESE ELIZABETH WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	13550 WASHINGTON ST UNIT 2B
Second Line	:
City	:	THORNTON
State	:	CO
Zip	:	80241-1009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9301 LAS RAMBLAS CT UNIT D
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-4227
Country	:	US
Telephone Number	:	720-828-7355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2019
Last Update Date	:	07/08/2019

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