Provider Demographics
NPI:1255854386
Name:WILLIAMS, ABIGAIL (LISW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 TRIPLE CROWN DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-9073
Mailing Address - Country:US
Mailing Address - Phone:641-257-9684
Mailing Address - Fax:
Practice Address - Street 1:5380 TRIPLE CROWN DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-9073
Practice Address - Country:US
Practice Address - Phone:641-257-9684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0877731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0074575Medicaid