Healthcare Provider Details

I. General information

NPI: 1669180907
Provider Name (Legal Business Name): LORRAINE WILLIAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DEERFIELD RD
WINDSOR CT
06095-4252
US

IV. Provider business mailing address

100 DEERFIELD RD
WINDSOR CT
06095-4252
US

V. Phone/Fax

Practice location:
  • Phone: 860-270-0600
  • Fax: 860-748-4432
Mailing address:
  • Phone: 860-270-0600
  • Fax: 860-748-4432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15428
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: