MEDICARE: WILLIAMS COUNSELING & RESOURCE CENTER LLC.

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	1041C0700X	Clinical Social Worker	5090-C	NV

General Provider Information

NPI Number	:	1568917474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS COUNSELING & RESOURCE CENTER LLC.

Provider Business Mailing Address
First Line	:	326 PARROT HILL AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-9071
Country	:	US
Telephone Number	:	702-994-5507
Fax Number	:

Provider Business Practice Location Address
First Line	:	4326 W CHEYENNE AVE STE 109
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2484
Country	:	US
Telephone Number	:	702-994-3507
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/PRESIDENT
Name	:	KATHY C WILLIAMS
Credential	:	LCSW
Telephone Number	:	702-994-3507

Provider Enumeration Date	:	08/20/2016
Last Update Date	:	05/20/2019

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