MEDICARE: MS. KATHY J WILLIAMS L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LSW0000000349	TN

General Provider Information

NPI Number	:	1619916376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHY J WILLIAMS L.C.S.W.

Provider Business Mailing Address
First Line	:	2241 DELTA WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-9108
Country	:	US
Telephone Number	:	865-694-8685
Fax Number	:

Provider Business Practice Location Address
First Line	:	2060 LAKESIDE CENTRE WAY
Second Line	:	SUITE 1
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-6591
Country	:	US
Telephone Number	:	865-531-2714
Fax Number	:	865-693-8250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/08/2007

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