Provider Demographics
NPI:1417366071
Name:WILLIAMSON, KORI NICOLE
Entity Type:Individual
Prefix:MRS
First Name:KORI
Middle Name:NICOLE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 KESSLER BOULEVARD EAST DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2890
Mailing Address - Country:US
Mailing Address - Phone:317-840-3422
Mailing Address - Fax:
Practice Address - Street 1:5638 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-5042
Practice Address - Country:US
Practice Address - Phone:888-714-1927
Practice Address - Fax:317-247-8935
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker