Provider Demographics
NPI:1689725210
Name:WILLIAMS-LATNIE, VERONICA M (PHD, MSW BCD, ACSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:M
Last Name:WILLIAMS-LATNIE
Suffix:
Gender:F
Credentials:PHD, MSW BCD, ACSW
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:M
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, MSW BCD, ACSW
Mailing Address - Street 1:225 E 5TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1641
Mailing Address - Country:US
Mailing Address - Phone:810-406-4941
Mailing Address - Fax:810-234-7068
Practice Address - Street 1:2900 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-4452
Practice Address - Country:US
Practice Address - Phone:810-789-9141
Practice Address - Fax:810-789-9222
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010109201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B56065038OtherMEDICARE PART B
MI0892478Medicare UPIN