Provider Demographics
NPI:1881954527
Name:MITCHELL-WILLIAMS, JENISE (LCSW, LISW- SP)
Entity type:Individual
Prefix:
First Name:JENISE
Middle Name:
Last Name:MITCHELL-WILLIAMS
Suffix:
Gender:F
Credentials:LCSW, LISW- SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6190 GIRBY RD APT 2921
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3394
Mailing Address - Country:US
Mailing Address - Phone:404-308-6907
Mailing Address - Fax:
Practice Address - Street 1:6190 GIRBY RD APT 2921
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3394
Practice Address - Country:US
Practice Address - Phone:404-308-6907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-28
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW005677104100000X
FL182731041C0700X
AL5373C1041C0700X
GACSW0056901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker