Healthcare Provider Details

I. General information

NPI: 1114337367
Provider Name (Legal Business Name): MARISA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3617 GEN PERSHING ST
NEW ORLEANS LA
70125-4530
US

IV. Provider business mailing address

3617 GEN PERSHING ST
NEW ORLEANS LA
70125-4530
US

V. Phone/Fax

Practice location:
  • Phone: 504-373-5338
  • Fax:
Mailing address:
  • Phone: 504-909-2719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number13566
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: