Provider Demographics
NPI:1467100172
Name:WILLIAMS, JODI (MSW)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 SCENIC DR STE 201
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-2466
Mailing Address - Country:US
Mailing Address - Phone:423-235-1471
Mailing Address - Fax:
Practice Address - Street 1:401 SCENIC DR STE 201
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-2466
Practice Address - Country:US
Practice Address - Phone:423-235-1471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13636104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker