Provider Demographics
NPI:1710087242
Name:WILLIAMS, LUCILLE R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LUCILLE
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 LOBLOLLY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-7655
Mailing Address - Country:US
Mailing Address - Phone:434-963-0324
Mailing Address - Fax:
Practice Address - Street 1:1441 SACHEM PL UNIT 4
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2555
Practice Address - Country:US
Practice Address - Phone:434-296-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040002221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical