Provider Demographics
NPI:1366638678
Name:WILLIAMS, COLBERT BERNARD SR (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:COLBERT
Middle Name:BERNARD
Last Name:WILLIAMS
Suffix:SR
Gender:M
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 1:44709 DATE AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3101
Mailing Address - Country:US
Mailing Address - Phone:866-726-7881
Mailing Address - Fax:661-940-9317
Practice Address - Street 1:2058 E OLDFIELD ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-1727
Practice Address - Country:US
Practice Address - Phone:866-726-7881
Practice Address - Fax:661-940-9317
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS185311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical