Provider Demographics
NPI:1558032748
Name:WILLIAMS, ALEXIS LYNN (LMSW, CASAC-T)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ELGAR PL APT 25G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-5039
Mailing Address - Country:US
Mailing Address - Phone:914-320-7481
Mailing Address - Fax:
Practice Address - Street 1:150 HUGUENOT ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5204
Practice Address - Country:US
Practice Address - Phone:914-613-0700
Practice Address - Fax:914-636-5231
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105435-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker