Provider Demographics
NPI:1558970095
Name:WILLIAMS, NICOLE TAYLOR (MSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:TAYLOR
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N HOMEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2411
Mailing Address - Country:US
Mailing Address - Phone:440-799-1774
Mailing Address - Fax:
Practice Address - Street 1:2516 JANE STREET, SUITES 200 AND 205
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2216
Practice Address - Country:US
Practice Address - Phone:412-265-1131
Practice Address - Fax:412-265-6531
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW142942104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2877463Medicaid