Provider Demographics
NPI:1801998315
Name:WILLIAMS, CAROL YVONNE (PHD,LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:YVONNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 NORTH 123 BYPASS
Mailing Address - Street 2:#4
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155
Mailing Address - Country:US
Mailing Address - Phone:830-433-5076
Mailing Address - Fax:830-433-5076
Practice Address - Street 1:628 N 123 BYPASS
Practice Address - Street 2:#4
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155
Practice Address - Country:US
Practice Address - Phone:830-433-5076
Practice Address - Fax:830-433-5076
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS137991041C0700X
TX564161041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9026932Medicare UPIN
TX56416Medicare UPIN