Provider Demographics
NPI:1669927653
Name:WILLIAMS-EPHRIAM, IMANI ARIEL (MSW LCSW QS)
Entity type:Individual
Prefix:
First Name:IMANI
Middle Name:ARIEL
Last Name:WILLIAMS-EPHRIAM
Suffix:
Gender:F
Credentials:MSW LCSW QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 E LAS OLAS BLVD # 1590
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2334
Mailing Address - Country:US
Mailing Address - Phone:545-604-2799
Mailing Address - Fax:954-522-5174
Practice Address - Street 1:1816 E OAKLAND PARK BLVD APT 61
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1118
Practice Address - Country:US
Practice Address - Phone:954-560-4279
Practice Address - Fax:954-522-5174
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 1041C0700X
SW174881041C0700X
FLSW174881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1669927653OtherPERSONAL NPI
1619584307OtherPRIVATE PRACTICE NPI