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NPI Code Detail

MEDICARE: MICHELLE M. WILLIAMS LCSW

MEDICARE: MICHELLE M. WILLIAMS LCSW
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
11041C0700XClinical Social Worker3681KY

General Provider Information

NPI Number : 1639589062
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE M. WILLIAMS LCSW
Provider Business Mailing Address
First Line : 32 GLENRIDGE DR
Second Line :
City : COLD SPRING
State : KY
Zip : 41076-9087
Country : US
Telephone Number : 859-441-4954
Fax Number :
Provider Business Practice Location Address
First Line : 100 CARMEL MANOR DR
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-2300
Country : US
Telephone Number : 502-262-2887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2014
Last Update Date : 02/21/2019

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