Healthcare Provider Details

I. General information

NPI: 1164845285
Provider Name (Legal Business Name): DORIS J. WILLIAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2014
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 DULUTH HWY SUITE 201
LAWRENCEVILLE GA
30046-7645
US

IV. Provider business mailing address

1835 SAVOY DR SUITE 300
ATLANTA GA
30341-1072
US

V. Phone/Fax

Practice location:
  • Phone: 770-822-0788
  • Fax: 770-822-0326
Mailing address:
  • Phone: 678-288-9555
  • Fax: 678-288-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW004223
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: