Provider Demographics
NPI:1881861870
Name:WILLIAMS, JUDITH MCLAURIN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:MCLAURIN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:VIVIAN
Other - Last Name:MCLAURIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:8175 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5377
Mailing Address - Country:US
Mailing Address - Phone:269-321-5033
Mailing Address - Fax:269-321-5001
Practice Address - Street 1:8175 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5377
Practice Address - Country:US
Practice Address - Phone:269-321-5033
Practice Address - Fax:269-321-5001
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801021619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health