Provider Demographics
NPI:1558489187
Name:WILLIAMS, NORA ROTH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NORA
Middle Name:ROTH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 NE LOOP 410
Mailing Address - Street 2:STE 901
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209
Mailing Address - Country:US
Mailing Address - Phone:210-822-2478
Mailing Address - Fax:210-804-1887
Practice Address - Street 1:1635 NE LOOP 410
Practice Address - Street 2:STE 901
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209
Practice Address - Country:US
Practice Address - Phone:210-822-2478
Practice Address - Fax:210-804-1887
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLCSW34931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX544KMedicare ID - Type Unspecified