Provider Demographics
NPI:1235518598
Name:WILLIAMSON, SARA LANE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LANE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7381 NAVARRE PKWY UNIT 1113
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7489
Mailing Address - Country:US
Mailing Address - Phone:217-621-3037
Mailing Address - Fax:
Practice Address - Street 1:7381 NAVARRE PKWY UNIT 1113
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7489
Practice Address - Country:US
Practice Address - Phone:217-621-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490172091041C0700X
IL149.0172091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical