Provider Demographics
NPI:1821613563
Name:WILLIAMS, MAEGAN (LSW)
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9684 KINSMAN PYMATUNING RD
Mailing Address - Street 2:
Mailing Address - City:KINSMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44428-9313
Mailing Address - Country:US
Mailing Address - Phone:330-770-8405
Mailing Address - Fax:
Practice Address - Street 1:311 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1977
Practice Address - Country:US
Practice Address - Phone:234-806-4102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1903521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker