Provider Demographics
NPI:1326218363
Name:WILLIAMS, JENNIFER JEAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EAMC 300 E. HOSPITAL ROAD ROOM 12C -05
Mailing Address - Street 2:
Mailing Address - City:FT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5650
Mailing Address - Country:US
Mailing Address - Phone:706-787-1380
Mailing Address - Fax:
Practice Address - Street 1:300 E. HOSPITAL ROAD ROOM 13A-10
Practice Address - Street 2:
Practice Address - City:FT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5650
Practice Address - Country:US
Practice Address - Phone:706-787-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040006131041C0700X
SC132511041C0700X
GACSW0033831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8914290Medicaid