Provider Demographics
NPI:1013056175
Name:WILLIAMS, MILLIE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MILLIE
Middle Name:ANN
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 1:801 2ND ST N
Mailing Address - Street 2:SUITE G
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-3517
Mailing Address - Country:US
Mailing Address - Phone:727-725-8820
Mailing Address - Fax:727-725-8361
Practice Address - Street 1:801 2ND ST N
Practice Address - Street 2:SUITE G
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3517
Practice Address - Country:US
Practice Address - Phone:727-725-8820
Practice Address - Fax:727-725-8361
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 11491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6318Medicare ID - Type Unspecified