Provider Demographics
NPI:1730567389
Name:WILLIAMS, WILLIE LEWIS (MSW)
Entity type:Individual
Prefix:MR
First Name:WILLIE
Middle Name:LEWIS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 WESTOVER DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2465
Mailing Address - Country:US
Mailing Address - Phone:850-508-0289
Mailing Address - Fax:
Practice Address - Street 1:834 JACLIF CT
Practice Address - Street 2:# A
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-681-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker