Healthcare Provider Details

I. General information

NPI: 1114469954
Provider Name (Legal Business Name): KIMBERLY S SEWELL-WILLIAMS MSW,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4239 HIGHWAY 1192 STE 300
MARKSVILLE LA
71351-4772
US

IV. Provider business mailing address

4239 HIGHWAY 1192 STE 300
MARKSVILLE LA
71351-4772
US

V. Phone/Fax

Practice location:
  • Phone: 318-253-0677
  • Fax:
Mailing address:
  • Phone: 318-253-0677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14930
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: