Provider Demographics
NPI:1356541775
Name:WILLIAMS, NATASHA MARIE (LCSW, LICSW, CLC)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW, LICSW, CLC
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:MARIE
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4227 S MERIDIAN # C474
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3603
Mailing Address - Country:US
Mailing Address - Phone:360-999-7515
Mailing Address - Fax:
Practice Address - Street 1:1011 S L ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4002
Practice Address - Country:US
Practice Address - Phone:253-213-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW67018104100000X
WA174N00000X
WALW607145191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174N00000XOther Service ProvidersLactation Consultant, Non-RN