Healthcare Provider Details

I. General information

NPI: 1801996459
Provider Name (Legal Business Name): LLOYD THOMAS WILLIAMS L.I.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CEDAR ST
WORCESTER MA
01609-2505
US

IV. Provider business mailing address

9 CEDAR ST
WORCESTER MA
01609-2505
US

V. Phone/Fax

Practice location:
  • Phone: 508-753-2512
  • Fax: 508-755-8645
Mailing address:
  • Phone: 508-753-2512
  • Fax: 508-755-8645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1017555
License Number StateMA

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: