Provider Demographics
NPI:1043378995
Name:WILLIAMS, ANITA J (LBSW)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 165717
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75016-5717
Mailing Address - Country:US
Mailing Address - Phone:254-462-2259
Mailing Address - Fax:
Practice Address - Street 1:2709 HEZEKIAH DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4598
Practice Address - Country:US
Practice Address - Phone:254-462-2259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36644104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker