Provider Demographics
NPI:1801530738
Name:WILLIAMS, MELLANEY K (LCSW)
Entity type:Individual
Prefix:
First Name:MELLANEY
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 N TORREY PINES DR APT 2006
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-6538
Mailing Address - Country:US
Mailing Address - Phone:307-421-5703
Mailing Address - Fax:
Practice Address - Street 1:2051 N TORREY PINES DR APT 2006
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-6538
Practice Address - Country:US
Practice Address - Phone:307-421-5703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9879-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical