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NPI Code Detail

MEDICARE: JODY WILLIAMS LCSW

MEDICARE: JODY 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
11041C0700XClinical Social Worker4044-CNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922137124
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODY WILLIAMS LCSW
Provider Business Mailing Address
First Line : PO BOX 753762
Second Line :
City : LAS VEGAS
State : NV
Zip : 89136-3762
Country : US
Telephone Number : 702-292-5210
Fax Number :
Provider Business Practice Location Address
First Line : 3320 N BUFFALO DR STE 207
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7411
Country : US
Telephone Number : 702-720-2565
Fax Number : 702-552-5163
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 09/28/2021

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