Provider Demographics
NPI:1952729865
Name:WILLIAMS, ANNETTA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNETTA
Middle Name:
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 1:25 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-4221
Mailing Address - Country:US
Mailing Address - Phone:804-379-0400
Mailing Address - Fax:
Practice Address - Street 1:25 S UNION ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-4221
Practice Address - Country:US
Practice Address - Phone:804-957-9601
Practice Address - Fax:804-957-5850
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040085311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical