Provider Demographics
NPI:1376081307
Name:DAVIDSON, WILLIAM PAUL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PAUL
Last Name:DAVIDSON
Suffix:
Gender:M
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:PO BOX 1332
Mailing Address - Street 2:
Mailing Address - City:NOBLE
Mailing Address - State:OK
Mailing Address - Zip Code:73068-1332
Mailing Address - Country:US
Mailing Address - Phone:405-414-0669
Mailing Address - Fax:
Practice Address - Street 1:313 N 4TH ST
Practice Address - Street 2:APARTMENT 2
Practice Address - City:NOBLE
Practice Address - State:OK
Practice Address - Zip Code:73068-9612
Practice Address - Country:US
Practice Address - Phone:405-414-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical