Provider Demographics
NPI:1780069047
Name:BRUBAKER, WILLIAM SMITH SR (LCSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SMITH
Last Name:BRUBAKER
Suffix:SR
Gender:M
Credentials:LCSW
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Mailing Address - Street 1:1500 N WILMOT RD STE A200
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4416
Mailing Address - Country:US
Mailing Address - Phone:520-873-8562
Mailing Address - Fax:888-851-7021
Practice Address - Street 1:3295 W INA RD STE 125
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2195
Practice Address - Country:US
Practice Address - Phone:520-257-1168
Practice Address - Fax:520-306-4861
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2020-09-17
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Provider Licenses
StateLicense IDTaxonomies
AZLCSW-24571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical