Provider Demographics
NPI:1801968862
Name:WILLIAMS, SHIRLEY J (LICSW)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:WESTBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01581
Mailing Address - Country:US
Mailing Address - Phone:508-870-0647
Mailing Address - Fax:508-799-6325
Practice Address - Street 1:154 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTBORO
Practice Address - State:MA
Practice Address - Zip Code:01581
Practice Address - Country:US
Practice Address - Phone:508-870-0647
Practice Address - Fax:508-799-6325
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10218821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical