Provider Demographics
NPI:1881619146
Name:WILLIAMS, EARL (LCSW, MFT)
Entity type:Individual
Prefix:MR
First Name:EARL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LCSW, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 S LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3842
Mailing Address - Country:US
Mailing Address - Phone:714-557-8660
Mailing Address - Fax:714-557-8111
Practice Address - Street 1:3205 S LOWELL ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3842
Practice Address - Country:US
Practice Address - Phone:714-557-8660
Practice Address - Fax:714-557-8111
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 4201 MFT 6179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACSW 042100Medicaid
CACSW 042100Medicaid