Provider Demographics
NPI:1124365226
Name:WILLIAMS, VICKI RENEE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:RENEE
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 1:900 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-4723
Mailing Address - Country:US
Mailing Address - Phone:337-392-8118
Mailing Address - Fax:337-392-8571
Practice Address - Street 1:900 S 6TH ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4723
Practice Address - Country:US
Practice Address - Phone:337-392-8118
Practice Address - Fax:337-392-8571
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8687104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker