Healthcare Provider Details

I. General information

NPI: 1073822680
Provider Name (Legal Business Name): ESTHER LEE WILLIAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2010
Last Update Date: 10/07/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 PINION DR
USAF ACADEMY CO
80840-2502
US

IV. Provider business mailing address

MENTAL HEALTH CLINIC 4102 PINION DRIVE
USAFA CO
80840
US

V. Phone/Fax

Practice location:
  • Phone: 719-333-5177
  • Fax:
Mailing address:
  • Phone: 719-333-5177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP006416
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC009006
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW004937
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: