Provider Demographics
NPI:1245569185
Name:WILLIAMSON, ANNE MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:409 PLYMOUTH RD STE 190
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1493
Mailing Address - Country:US
Mailing Address - Phone:734-459-6016
Mailing Address - Fax:
Practice Address - Street 1:192 N. MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170
Practice Address - Country:US
Practice Address - Phone:734-459-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI680-106-8377104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker