Provider Demographics
NPI:1750738811
Name:WILLIAMS, NICOYA (LGSW)
Entity type:Individual
Prefix:
First Name:NICOYA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5160 RICE RD
Practice Address - Street 2:APT194
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2052
Practice Address - Country:US
Practice Address - Phone:205-602-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health