Provider Demographics
NPI:1083389068
Name:WILLIAMS, CHRISTINE VANESSA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:VANESSA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 BENJAMIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3934
Mailing Address - Country:US
Mailing Address - Phone:229-802-8011
Mailing Address - Fax:
Practice Address - Street 1:615 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-3319
Practice Address - Country:US
Practice Address - Phone:229-891-7374
Practice Address - Fax:229-891-7163
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW009848101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health