Provider Demographics
NPI:1881226702
Name:WILLIAMS, DAWAYLA SHEREE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DAWAYLA
Middle Name:SHEREE
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 1:1500 KAREN AVE APT 354
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-8841
Mailing Address - Country:US
Mailing Address - Phone:209-915-1553
Mailing Address - Fax:
Practice Address - Street 1:4719 QUAIL LAKES DR STE G1046
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5267
Practice Address - Country:US
Practice Address - Phone:209-915-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8720-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical