Provider Demographics
NPI:1003165200
Name:WILLIAMS, YVETTE C (LCSW)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 SUMMIT CROSSING PL
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2192
Mailing Address - Country:US
Mailing Address - Phone:704-917-7610
Mailing Address - Fax:704-917-7615
Practice Address - Street 1:830 SUMMIT CROSSING PL
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2192
Practice Address - Country:US
Practice Address - Phone:704-917-7610
Practice Address - Fax:704-917-7615
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP00655551041C0700X
NCC0092151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical