Provider Demographics
NPI:1881397065
Name:WILLIAMS, MARIA T (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:T
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:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:CORTARO
Mailing Address - State:AZ
Mailing Address - Zip Code:85652-0040
Mailing Address - Country:US
Mailing Address - Phone:432-294-2773
Mailing Address - Fax:
Practice Address - Street 1:350 E MORNINGSIDE RD
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-5152
Practice Address - Country:US
Practice Address - Phone:520-648-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261Q00000X
AZLCSW-211911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center