Provider Demographics
NPI:1982770152
Name:ASHLEY-WILLIAMS, STACIE ARTELLIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:ARTELLIA
Last Name:ASHLEY-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 4027
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-4027
Mailing Address - Country:US
Mailing Address - Phone:562-275-8454
Mailing Address - Fax:562-275-8311
Practice Address - Street 1:10900 183RD ST STE 105
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5375
Practice Address - Country:US
Practice Address - Phone:562-275-8454
Practice Address - Fax:562-275-8311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CALCS206981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker