Provider Demographics
NPI:1619185808
Name:WILLIAMS, ROSELYN DENISE (MSW)
Entity Type:Individual
Prefix:MS
First Name:ROSELYN
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ROSELYN
Other - Middle Name:DENISE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:4100 GLENN DALE RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3577
Mailing Address - Country:US
Mailing Address - Phone:301-262-8328
Mailing Address - Fax:
Practice Address - Street 1:4100 GLENN DALE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3577
Practice Address - Country:US
Practice Address - Phone:301-262-8328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD054401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD05440OtherLCSW-C