Provider Demographics
NPI:1548380751
Name:WILLIAMS, MELANIE M (LCSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:MCCARRAHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:125 TIMBER OAK DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-3065
Mailing Address - Country:US
Mailing Address - Phone:276-696-1899
Mailing Address - Fax:
Practice Address - Street 1:125 TIMBER OAK DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3065
Practice Address - Country:US
Practice Address - Phone:276-696-1899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00009871041C0700X
TN54941041C0700X
VA09040085941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE12001318OtherCAQH