Provider Demographics
NPI:1467472506
Name:WILLIAMS, VERYL R (LMSW, PHD)
Entity Type:Individual
Prefix:MRS
First Name:VERYL
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87474
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-0474
Mailing Address - Country:US
Mailing Address - Phone:734-740-4585
Mailing Address - Fax:734-484-5475
Practice Address - Street 1:39555 ORCHARD HILL PL
Practice Address - Street 2:SUITE 600, PMB 6234
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5374
Practice Address - Country:US
Practice Address - Phone:734-740-4585
Practice Address - Fax:734-484-5475
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010857961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical