Provider Demographics
NPI:1881866127
Name:WILLIAMS, TINA E (LCSW)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:E
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 1:3500 E FLETCHER AVE
Mailing Address - Street 2:SUITE 129
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4708
Mailing Address - Country:US
Mailing Address - Phone:813-340-3577
Mailing Address - Fax:813-978-0475
Practice Address - Street 1:3500 E FLETCHER AVE
Practice Address - Street 2:SUITE 129
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4708
Practice Address - Country:US
Practice Address - Phone:813-340-3577
Practice Address - Fax:813-978-0475
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW72581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical