MEDICARE: MS. LAW'RENE E. WILLIAMS M.S COUNSELOR

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	101YM0800X	Mental Health Counselor
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1124192232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAW'RENE E. WILLIAMS M.S COUNSELOR

Provider Business Mailing Address
First Line	:	1508 ANDREW DAVID AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1348
Country	:	US
Telephone Number	:	619-248-7494
Fax Number	:

Provider Business Practice Location Address
First Line	:	1508 ANDREW DAVID AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1348
Country	:	US
Telephone Number	:	619-248-7494
Fax Number	:

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	09/02/2010

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