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NPI Code Detail

MEDICARE: MISS PAMELA LYNETTE WILLIAMS RSW/CAC

MEDICARE: MISS PAMELA LYNETTE WILLIAMS RSW/CAC
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
1171M00000XCase Manager/Care Coordinator7726LA
2101YA0400XAddiction (Substance Use Disorder) Counselor1606LA

General Provider Information

NPI Number : 1740392281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS PAMELA LYNETTE WILLIAMS RSW/CAC
Provider Business Mailing Address
First Line : 1310 N HEARNE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-6516
Country : US
Telephone Number : 318-676-5111
Fax Number : 318-676-5137
Provider Business Practice Location Address
First Line : 1310 N HEARNE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-6516
Country : US
Telephone Number : 318-676-5111
Fax Number : 318-676-5137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/22/2021

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1417987082 — MS. TERRI GREEN-ANDERSON LMSW, LAC
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Directions to “ MISS PAMELA LYNETTE WILLIAMS RSW/CAC” Practice Location

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