Provider Demographics
NPI:1083059141
Name:WILLIAMS, JOYCE LENISE (LMSW, MSSW, CAADC)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:LENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW, MSSW, CAADC
Other - Prefix:MS
Other - First Name:JOYCE
Other - Middle Name:LENISE
Other - Last Name:CONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, CAADC
Mailing Address - Street 1:300 68TH ST SE
Mailing Address - Street 2:PO BOX 165
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49548-6927
Mailing Address - Country:US
Mailing Address - Phone:616-281-6363
Mailing Address - Fax:616-831-2608
Practice Address - Street 1:1440 FULLER AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-2191
Practice Address - Country:US
Practice Address - Phone:616-235-2865
Practice Address - Fax:616-235-2938
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801092955251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI12533835OtherCAQH