Provider Demographics
NPI:1114138096
Name:WILLIAMS, PRISCILLA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 774
Mailing Address - Street 2:1040 JOHN WILLIAMS ROAD
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-0774
Mailing Address - Country:US
Mailing Address - Phone:803-526-6016
Mailing Address - Fax:
Practice Address - Street 1:302 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4506
Practice Address - Country:US
Practice Address - Phone:704-882-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005660101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health