Provider Demographics
NPI:1861978397
Name:WILLIAMS, MARIANETA (LMSW)
Entity type:Individual
Prefix:
First Name:MARIANETA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6949 PARK DR E # 2R
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1934
Mailing Address - Country:US
Mailing Address - Phone:347-239-8413
Mailing Address - Fax:
Practice Address - Street 1:119 SCHENECTADY AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2330
Practice Address - Country:US
Practice Address - Phone:347-915-1112
Practice Address - Fax:347-915-1113
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100370104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker