Provider Demographics
NPI:1306012323
Name:WILLIAMS, LAURA ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
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 6548
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-6548
Mailing Address - Country:US
Mailing Address - Phone:808-895-0989
Mailing Address - Fax:
Practice Address - Street 1:65-1229A OPELO RD.
Practice Address - Street 2:HANA HOU COTTAGES #3
Practice Address - City:KAMEULA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-895-0989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW - 30501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical