Provider Demographics
NPI:1245644434
Name:WILLIAMS, KIRRA ANGELLE (LCSW)
Entity type:Individual
Prefix:
First Name:KIRRA
Middle Name:ANGELLE
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 1:8302 OXFORD VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MABELVALE
Mailing Address - State:AR
Mailing Address - Zip Code:72103-2331
Mailing Address - Country:US
Mailing Address - Phone:501-508-9822
Mailing Address - Fax:
Practice Address - Street 1:8302 OXFORD VALLEY DR
Practice Address - Street 2:
Practice Address - City:MABELVALE
Practice Address - State:AR
Practice Address - Zip Code:72103-2331
Practice Address - Country:US
Practice Address - Phone:501-508-9822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6725-C1041C0700X
AR6725-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical