Provider Demographics
NPI:1679155626
Name:WILLIAMS, MELISSA CAROLINE (LICSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CAROLINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 QUEEN ST NE APT 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2860
Mailing Address - Country:US
Mailing Address - Phone:706-525-8299
Mailing Address - Fax:
Practice Address - Street 1:2001 S ST NW STE 310
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1164
Practice Address - Country:US
Practice Address - Phone:706-525-8299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC50082958104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker