Provider Demographics
NPI:1710583653
Name:WILLIAMS, CHATONIA
Entity Type:Individual
Prefix:
First Name:CHATONIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8045 BIG BEND BLVD STE 101&109
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2709
Mailing Address - Country:US
Mailing Address - Phone:314-800-0311
Mailing Address - Fax:314-228-0367
Practice Address - Street 1:8045 BIG BEND BLVD STE 101&109
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-2709
Practice Address - Country:US
Practice Address - Phone:314-800-0311
Practice Address - Fax:314-228-0367
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210475801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical