Provider Demographics
NPI:1255645263
Name:MCWILLIAMS, JAN M (LCSW)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:M
Last Name:MCWILLIAMS
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 1:1142 DIBBLE RD SW
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3306
Mailing Address - Country:US
Mailing Address - Phone:912-547-0399
Mailing Address - Fax:
Practice Address - Street 1:1142 DIBBLE RD SW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3306
Practice Address - Country:US
Practice Address - Phone:912-547-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0019061041C0700X
SC85951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical