Provider Demographics
NPI:1073659348
Name:WILLIAMS, SEYREL (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SEYREL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1481
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1481
Mailing Address - Country:US
Mailing Address - Phone:978-525-2111
Mailing Address - Fax:978-526-1284
Practice Address - Street 1:16 DEER COVE ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-3120
Practice Address - Country:US
Practice Address - Phone:978-525-2111
Practice Address - Fax:978-526-1284
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1068641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical