Healthcare Provider Details

I. General information

NPI: 1700140472
Provider Name (Legal Business Name): ROBERT DEAN WILLIAMS MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 INDIAN HILLS DR
MACY NE
68039-3023
US

IV. Provider business mailing address

100 INDIAN HILLS DR PO BOX 250
MACY NE
68039-3023
US

V. Phone/Fax

Practice location:
  • Phone: 402-837-5381
  • Fax:
Mailing address:
  • Phone: 402-837-5381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1595
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number000397
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: