Provider Demographics
NPI:1922640846
Name:WILLIAMS, NIKOLE MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:NIKOLE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NIKOLE
Other - Middle Name:M
Other - Last Name:BRATCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6616 N CRYSTAL AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-5446
Mailing Address - Country:US
Mailing Address - Phone:816-695-0970
Mailing Address - Fax:
Practice Address - Street 1:6301 ROCKHILL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1124
Practice Address - Country:US
Practice Address - Phone:913-626-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230345141041C0700X
104100000X
MO2020011391104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical