Healthcare Provider Details

I. General information

NPI: 1225754153
Provider Name (Legal Business Name): ERICA DANIELLE WILLIAMS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 VETERANS BLVD
DUBLIN GA
31021-3620
US

IV. Provider business mailing address

PO BOX 115
GORDON AL
36343-0115
US

V. Phone/Fax

Practice location:
  • Phone: 800-595-5229
  • Fax:
Mailing address:
  • Phone: 334-200-5466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: