Provider Demographics
NPI:1538975461
Name:WILLIAMS, JENNIFER (MSW,LCSW-A)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:MSW,LCSW-A
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:FORRESTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-A
Mailing Address - Street 1:3420 SAND POST OAK CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-0049
Mailing Address - Country:US
Mailing Address - Phone:718-374-7390
Mailing Address - Fax:
Practice Address - Street 1:3420 SAND POST OAK CT
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-0049
Practice Address - Country:US
Practice Address - Phone:718-374-7390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0214821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty