Provider Demographics
NPI:1508549940
Name:WILLIAMS, SHURONDIA C (BS, MSW, LCSW-A)
Entity Type:Individual
Prefix:MS
First Name:SHURONDIA
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BS, MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 N GARNETT ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-4368
Mailing Address - Country:US
Mailing Address - Phone:252-915-8403
Mailing Address - Fax:
Practice Address - Street 1:404 N GARNETT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4368
Practice Address - Country:US
Practice Address - Phone:252-915-8403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC253Z00000X, 253Z00000X
NCPO197981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical