Provider Demographics
NPI:1811201999
Name:WILLIAMS, LAYSHA TAYLOR (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAYSHA
Middle Name:TAYLOR
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 ELDERBERRY CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-7876
Mailing Address - Country:US
Mailing Address - Phone:252-220-4781
Mailing Address - Fax:252-937-7981
Practice Address - Street 1:876 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1707
Practice Address - Country:US
Practice Address - Phone:252-220-4781
Practice Address - Fax:252-937-7981
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0068221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical