Provider Demographics
NPI:1093458564
Name:WILLIAMSON, CLARHONDA (LLMSW)
Entity Type:Individual
Prefix:
First Name:CLARHONDA
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30986 STONE RIDGE DR APT 14213
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-3891
Mailing Address - Country:US
Mailing Address - Phone:248-993-4937
Mailing Address - Fax:
Practice Address - Street 1:30986 STONE RIDGE DR APT 14213
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-3891
Practice Address - Country:US
Practice Address - Phone:248-993-4937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851109943104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker