Provider Demographics
NPI:1114626868
Name:WILLIAMS, RODERICK (LMSW)
Entity Type:Individual
Prefix:
First Name:RODERICK
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 BIRCH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIO VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:94571-2211
Mailing Address - Country:US
Mailing Address - Phone:205-821-2027
Mailing Address - Fax:
Practice Address - Street 1:644 BIRCH RIDGE DR
Practice Address - Street 2:
Practice Address - City:RIO VISTA
Practice Address - State:CA
Practice Address - Zip Code:94571-2211
Practice Address - Country:US
Practice Address - Phone:205-821-2027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker