Provider Demographics
NPI:1649886607
Name:WILLIAMS, MELISSA LYNN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41221 CHICKADEE ST
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-9789
Mailing Address - Country:US
Mailing Address - Phone:616-706-0961
Mailing Address - Fax:
Practice Address - Street 1:319 W DELAWARE ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:MI
Practice Address - Zip Code:49045-1106
Practice Address - Country:US
Practice Address - Phone:269-423-7028
Practice Address - Fax:269-423-8282
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010927031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical