Provider Demographics
NPI:1164024907
Name:WILLIAMS, SHAQUANUS (LCSW)
Entity type:Individual
Prefix:
First Name:SHAQUANUS
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHAQUANUS
Other - Middle Name:
Other - Last Name:DAILEY WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2524 PARKSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-1120
Mailing Address - Country:US
Mailing Address - Phone:770-317-6392
Mailing Address - Fax:
Practice Address - Street 1:2524 PARKSIDE WAY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-1120
Practice Address - Country:US
Practice Address - Phone:770-317-6392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0092191041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool