Provider Demographics
NPI:1861647471
Name:WILLIAMS, MARILYN SUZETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:SUZETTE
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 1:1103 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3005
Mailing Address - Country:US
Mailing Address - Phone:985-646-1531
Mailing Address - Fax:
Practice Address - Street 1:1103 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3005
Practice Address - Country:US
Practice Address - Phone:985-646-1531
Practice Address - Fax:985-646-1531
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6401104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker