Provider Demographics
NPI:1649343757
Name:WEBER, WILLIAM (MFT, LADC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WEBER
Suffix:
Gender:M
Credentials:MFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-5377
Mailing Address - Country:US
Mailing Address - Phone:775-786-8801
Mailing Address - Fax:775-786-8536
Practice Address - Street 1:501 W 1ST ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5377
Practice Address - Country:US
Practice Address - Phone:775-786-8801
Practice Address - Fax:775-786-8536
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00464L101YA0400X
NV0602106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0602OtherMFT
NV00464LOtherLADC