| Jody Williams, Lcsw, Llc | |
|
3320 N Buffalo Dr Ste 207 Las Vegas NV 89129-7411 | |
| (702) 720-2565 | |
| (702) 552-5163 |
| Full Name | Jody Williams, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3320 N Buffalo Dr Ste 207, Las Vegas, Nevada |
| Authorized Official Name and Position | Jody Williams (OWNER) |
| Authorized Official Contact | 7027202565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jody Williams, Lcsw, Llc Po Box 753762 Las Vegas NV 89136-3762 Ph: (702) 720-2565 | Jody Williams, Lcsw, Llc 3320 N Buffalo Dr Ste 207 Las Vegas NV 89129-7411 Ph: (702) 720-2565 |
| NPI Number | 1023697364 |
|---|---|
| Provider Enumeration Date | 04/05/2021 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 4082135611 |
|---|---|
| Medicare Enrollment ID | O20250311002696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023697364 | NPI | - | NPPES |
| 100509776 | Medicaid | NV | |
| 100509777 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jody Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922137124 PECOS PAC ID: 9436670064 Enrollment ID: I20250311002821 |
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