Provider Demographics
NPI:1801697404
Name:WILLIAMS, DENISE LYNN (CHW, CCSS, CPSW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:CHW, CCSS, CPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6727
Mailing Address - Country:US
Mailing Address - Phone:575-491-3628
Mailing Address - Fax:
Practice Address - Street 1:1211 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6727
Practice Address - Country:US
Practice Address - Phone:575-491-3628
Practice Address - Fax:575-491-3628
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMG-1709172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker