Provider Demographics
NPI:1720381544
Name:WILLIAMS, ALISON BROOKE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:BROOKE
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 1:2705 KIMBERLAND CT
Mailing Address - Street 2:
Mailing Address - City:STATHAM
Mailing Address - State:GA
Mailing Address - Zip Code:30666-2459
Mailing Address - Country:US
Mailing Address - Phone:706-280-6505
Mailing Address - Fax:888-285-5215
Practice Address - Street 1:235 E PONCE DE LEON AVE
Practice Address - Street 2:STE 110
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3452
Practice Address - Country:US
Practice Address - Phone:706-280-6505
Practice Address - Fax:888-285-5215
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0040011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical