Provider Demographics
NPI:1881216869
Name:WILLIAMS, AUNJREALISHA (LGSW)
Entity Type:Individual
Prefix:
First Name:AUNJREALISHA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 BROOKS DR APT 520
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1035
Mailing Address - Country:US
Mailing Address - Phone:540-877-8734
Mailing Address - Fax:
Practice Address - Street 1:1130 VARNEY ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4372
Practice Address - Country:US
Practice Address - Phone:202-450-5822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50081823104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker