Provider Demographics
NPI:1073687398
Name:WILLIAMS, EMMA J (LCSW, LMFT)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 W WISCONSIN AVE
Mailing Address - Street 2:STE 5190
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-2601
Mailing Address - Country:US
Mailing Address - Phone:414-272-5005
Mailing Address - Fax:414-272-3760
Practice Address - Street 1:161 W WISCONSIN AVE
Practice Address - Street 2:STE 5190
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203-2601
Practice Address - Country:US
Practice Address - Phone:414-272-5005
Practice Address - Fax:414-272-3760
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI249-124106H00000X
WI1934-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39657200Medicaid
WI42186800Medicaid
WI39657200Medicaid