Provider Demographics
NPI:1942734959
Name:WILLIAMS, MICHELLE (BSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 S GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3308
Mailing Address - Country:US
Mailing Address - Phone:419-371-0769
Mailing Address - Fax:
Practice Address - Street 1:658 W MARKET ST
Practice Address - Street 2:101
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4653
Practice Address - Country:US
Practice Address - Phone:419-222-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker