Provider Demographics
NPI:1487864211
Name:WILLIAMSON, BARBARA G (MA, LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:G
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MA, LCSW
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 260331
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-0331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:935 W RALPH HALL PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-8701
Practice Address - Country:US
Practice Address - Phone:972-742-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124175405Medicaid
TX124175406Medicaid
TXTXB117143Medicare PIN
TX124175405Medicaid
TX124175406Medicaid
TXTXB101498Medicare PIN