Provider Demographics
NPI:1780084954
Name:WILLIAMS, JACQUELINE TOLSON (LCSW)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:TOLSON
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 1:59 DAMONTE RANCH PARKWAY
Mailing Address - Street 2:B, #228
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-1459
Mailing Address - Country:US
Mailing Address - Phone:775-386-2333
Mailing Address - Fax:
Practice Address - Street 1:59 DAMONTE RANCH PARKWAY
Practice Address - Street 2:B, #228
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-1459
Practice Address - Country:US
Practice Address - Phone:775-386-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2023-11-26
Deactivation Date:2023-10-30
Deactivation Code:
Reactivation Date:2023-11-17
Provider Licenses
StateLicense IDTaxonomies
NV9475-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical