Provider Demographics
NPI:1265276752
Name:WILLIAMS, CENEICE (LSW)
Entity type:Individual
Prefix:
First Name:CENEICE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 W 144TH ST APT D
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60827-2851
Mailing Address - Country:US
Mailing Address - Phone:708-870-1466
Mailing Address - Fax:
Practice Address - Street 1:68 W 144TH ST APT D
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:IL
Practice Address - Zip Code:60827-2851
Practice Address - Country:US
Practice Address - Phone:708-870-1466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.111198104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker