Provider Demographics
NPI:1316182314
Name:WILLIAMS, RAQUELE (LCSW)
Entity Type:Individual
Prefix:
First Name:RAQUELE
Middle Name:
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 1:860 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3466
Mailing Address - Country:US
Mailing Address - Phone:718-924-6602
Mailing Address - Fax:
Practice Address - Street 1:111 5TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1005
Practice Address - Country:US
Practice Address - Phone:607-289-3684
Practice Address - Fax:424-432-0470
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076997-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical