Provider Demographics
NPI:1245964709
Name:WILLIAMS, VICTORIA (LMSW, CSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW, CSW
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:MINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 EAGLES PERCH LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-2042
Mailing Address - Country:US
Mailing Address - Phone:931-249-2661
Mailing Address - Fax:
Practice Address - Street 1:124 EAGLES PERCH LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-2042
Practice Address - Country:US
Practice Address - Phone:931-249-2661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13747104100000X
KY255986104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker